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Biomedical subjects

C T Currie

Publications and source records attributed to C T Currie.

At least 19 recordsLinked to original sources
PubMed1996

Discharge of elderly people from an accident and emergency department: evaluation of health visitor follow-up.

Elderly people discharged directly home from an accident and emergency department are known to be a vulnerable group. The value of health visitor follow-up in patients aged 75 years and over was assessed in a random controlled trail; 222 intervention patients were seen at home by a research health visitor shortly after discharge and screened for new dependency and support needs, appropriate community services then being offered. These patients, and 192 controls for whom no special arrangements were made, were followed up four weeks later by a research occupational therapist. New dependency, most commonly trauma-related, was found in approximately 50%, and in the majority proved transient. Advice and/or referral to a wide range of services was offered to 92% of the intervention group. Service refusal rates were high in both groups. Compared to controls, intervention patients received more services and were significantly more independent at four weeks. Health visitor assessment was seen as helpful. In order to identify elderly accident and emergency department patients at risk following discharge, study data were used to derive a short questionnaire. In follow-up visits to 48 patients the use of this questionnaire was piloted, and its validity demonstrated. A number of study limitations and areas for development of discharge planning are discussed.

Activities of Daily Living↗
PubMed1996

Patterns of geriatric orthopaedic liaison in Scotland.

Despite increasing interest in collaboration between geriatricians and orthopaedic surgeons in the care of elderly trauma patients, there has been no systematic study to date of the extent of this collaboration in Scotland. This survey establishes the present patterns of such arrangements.

Aged↗
PubMed1992

Prospective study of necropsy audit of geriatric inpatient deaths.

AIMS: To evaluate the accuracy of clinical diagnosis by specialists in geriatric medicine and to compare this with a previous study involving non-specialists. METHOD: Clinical and necropsy diagnoses from consecutive hospital inpatient deaths from the University Department of Geriatric Medicine were analysed for discrepancies at regular audit meetings. Three main categories of diagnosis were considered and any therapeutic implications discussed. RESULTS: Between 1987 and 1989 necropsies were performed on 100 patients (38 men, 62 women, aged 63 to 99 years) from a total of 207 deaths, a necropsy rate of 50%. There was complete agreement between necropsy and clinical diagnoses in 32% of cases. Disagreement involved the main diagnosis in 28%, contributory conditions in 32%, and cause of death in 34%. In 10% of cases the diagnostic discrepancy was considered therapeutically important. Specialist geriatricians correctly diagnosed the main diagnosis in 72% of cases; non-specialists in the previous study were correct in only 47% of cases. CONCLUSION: Specialist geriatricians diagnose elderly people more accurately than non-specialists. But rates of misdiagnosis are still significant and necropsies continue to be a useful form of audit.

Aged↗
PubMed1989

Non-orthopaedic problems in the elderly on an acute orthopaedic unit: the case for geriatrician input.

Two hundred and fifty consecutive patients aged 70 years and over admitted to an acute orthopaedic unit were assessed with particular attention to their medical, social and functional status. The majority of patients were independent prior to admission and were discharged within six weeks. Prolonged hospital stay was associated wtih increasing age, multiple medical problems and poor pre-admission functional level, especially impaired mobility and cognition. A possible role for geriatric medical expertise in the early assessment and medical management of elderly orthopaedic patients is noted.

Age Factors↗
PubMed1984

Elderly patients discharged from an accident and emergency department--their dependency and support.

One hundred elderly patients who had attended an accident and emergency department and had been discharged were visited at home shortly afterwards. Compared to their previous level of function, 52 showed a minor or major increase in dependency, usually related to trauma. Scrutiny of accident and emergency records showed only scanty documentation of dependency, function and support arrangements. Available statutory services for dependent elderly in the community were under-utilized by these patients. In 39 of the 52 cases with increased dependency relatives had provided additional support.

Aftercare↗
PubMed1982

Functional disability in the hospitalized elderly.

Little documentation exists concerning the extent of functional disability in the hospitalized elderly and the impact of this disability on the care of these patients. A physician-led survey was conducted in a 400-bed community hospital of 279 patients aged 70 or more years. Considerable age-correlated disability was documented. Fifty-four percent of the patients aged 85 years or older were moderately or severely disoriented. Thirty-four percent had impaired hearing, 40% had impaired vision, and 25% had speech impairments. More than half of the patients 75 years or older needed assistance with activities of daily living. Modern hospital design and services may interfere with functional recovery. Evaluation of special care units to minimize the hazards of hospitalizing the elderly is recommended.

Activities of Daily Living↗
PubMed1981

Assessment of elderly patients at home: a report of fifty cases.

Fifty elderly patients were assessed at home by physicians trained in geriatric medicine. The patients had been referred by physicians, relatives, or community services. Reasons for referral usually were nonspecific and involved either a request for overall assessment or recommendations about placement. Assessment included medical, psychiatric, social and functional components. Mental impairment and impairment in the activities of daily living were common. New medical or psychiatric diagnoses were contributed in 36 instances. The most frequent previously unnoticed pathologic disorders were mental impairment and depression. Assessment resulted in specialists' advice concerning such matters as the medication program, placement, increased support, further diagnostic work and, in two instances, prompt admission to a hospital.

Activities of Daily Living↗
PubMed1980

A scheme of augmented home care for acutely and sub-acutely ill elderly patients: report on pilot study.

A pilot study for a scheme of augmented home care for elderly patients with acute or sub-acute illnesses is described. General practitioner care was supplemented by the services of a geriatrician. Home Help and District Nursing Services were involved where appropriate. Functional recovery was assessed using a new index based on the individual patient's pre-morbid function. Of 37 patients treated at home, six required admission to hospital and three died. The remainder made satisfactory functional recovery. Preliminary evidence suggests that in patients with comparable illness, recovery of function in terms of the Activities of Daily Living is more rapid at home than in hospital. This augmented home-care scheme proved practicable and acceptable to patients and participants and suggests that further controlled studies should be carried out.

Activities of Daily Living↗
PubMed1979

Contribution from geriatric medicine within acute medical wards.

In 1977 a scheme of attachment to acute medical wards of consultants in geriatric medicine and associated junior medical staff was instituted in a large Edinburgh teaching hospital. The effect on admissions of patients aged 65 and over was examined for comparable periods before and during this arrangement. Mean and median stays were reduced for both sexes but more noticeably for women. The mean stay for all women aged over 65 was reduced from 25 to 16 days and for women aged over 85 from 50 to 19 days. The proportion staying under two weeks was significantly increased in both sexes, and the proportion discharged home also increased, correspondingly fewer patients being transferred to convalescent wards. These changes were not accompanied by increased transfers to the geriatric department, and probably the skills and extra resources available to the geriatric service were the factors mainly responsible for the changes in performance.

Acute Disease↗