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Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.

Publication ,  Journal Article
Thornlow, DK; Oddone, E; Anderson, R
Published in: Res Gerontol Nurs
2014

During hospitalization, older adults are at high risk for cascade iatrogenesis, the serial development of complications. In this retrospective, descriptive, case-control pilot study, 28 patients (cases) who developed respiratory failure after an elective surgical procedure were compared to 28 matched controls who did not develop postoperative respiratory failure. The type, frequency, and timing of events that preceded the development of postoperative respiratory failure in hospitalized older adults (age 65 and older) and the presence and timing of similar events for matched controls during a postoperative period of the same length were recorded. Cases experienced certain trigger events, including atelectasis and fluid overload, at significantly higher rates than controls. Cases and controls experienced similar rates of oversedation and delirium, yet controls were less likely to aspirate following these episodes. Patients who developed postoperative respiratory failure were less likely to ambulate early and experienced more calls to rapid response or code teams, more transfers to higher levels of care, longer lengths of stay, and more deaths than matched controls.

Duke Scholars

Published In

Res Gerontol Nurs

DOI

ISSN

1940-4921

Publication Date

2014

Volume

7

Issue

2

Start / End Page

66 / 77

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory Insufficiency
  • Postoperative Complications
  • Pilot Projects
  • North Carolina
  • Models, Theoretical
  • Male
  • Length of Stay
  • Inpatients
 

Citation

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Thornlow, D. K., Oddone, E., & Anderson, R. (2014). Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults. Res Gerontol Nurs, 7(2), 66–77. https://doi.org/10.3928/19404921-20131126-01
Thornlow, Deirdre K., Eugene Oddone, and Ruth Anderson. “Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.Res Gerontol Nurs 7, no. 2 (2014): 66–77. https://doi.org/10.3928/19404921-20131126-01.
Thornlow, Deirdre K., et al. “Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.Res Gerontol Nurs, vol. 7, no. 2, 2014, pp. 66–77. Pubmed, doi:10.3928/19404921-20131126-01.

Published In

Res Gerontol Nurs

DOI

ISSN

1940-4921

Publication Date

2014

Volume

7

Issue

2

Start / End Page

66 / 77

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory Insufficiency
  • Postoperative Complications
  • Pilot Projects
  • North Carolina
  • Models, Theoretical
  • Male
  • Length of Stay
  • Inpatients