Shelley McDonald

[Shelley McDonald @agedoc100]

Exciting News! Duke Health's POSH model is inspiring global change! 🇰🇷 South Korea's first geriatric surgery optimization center, COGS, is now open, bringing Duke's innovative approach overseas. Kudos to Dr. Woo-Young Shin for leading the charge! 🌍

🔗 https://t.co/S7qZx4HVtU

[Peter Nydahl @NydahlPeter]

Meta Analysis incl 11 RCT and 3,113 ICU patients with family integration vs usual care found a significant reduction in risk of delirium (RR 0.46), delirium duration (WMD -2.18) and LoS in ICU, with different effects between specific interventions
https://t.co/VUZZxj9DCk

[Shelley McDonald @agedoc100]

Greed harms the cultures of compassion and professionalism that are bedrock to healing care.

First, health care professionals in all disciplines need to become noisier about the conflict between unchecked greed and the duty to heal.

https://t.co/mLw9LNViFB

[James Deardorff @wjdeardorff]

"Perioperative Use of Gabapentinoids for the Management of Postoperative Acute Pain: Meta-analysis" (2020) - "These results do not support the routine use of pregabalin or gabapentin for the management of postoperative pain in adult patients." - https://t.co/YeRyAcTRP6

[Kahli Zietlow @KahliGoBlue]

Love this @JAMAInternalMed teachable moment on nonpharm management of #cachexia. Address contributing conditions (nausea, oral ulcers), counsel on physiology, and set appropriate expectations - all more effective than medications!

[Grumpy Geriatrician @GeriatricDr]

Geriatric Medicine tip of the day: Distraction techniques and normal reassuring conversation are invaluable when dealing with agitated/anxious and delirious patients. Asking someone to relax is akin to saying “don’t look/no peeking”

[Jeanna Blitz @Jeanna_BlitzMD]

@preopconsult The outcomes for our patients @Duke_Anesthesia @DukeGeriatrics say otherwise. The PASS-POSH collaboration has published plenty on our effective model. Be on the lookout for more to come! @agedoc100 @RealMilesBerger @SPAQIedu

[Sarah Wingfield @swingfieldmd]

Delirium is a serious, costly and often preventable complication of elective surgery in older adults.

[Shelley McDonald @agedoc100]

$ 33 billion in total direct 1-year health care costs attributable to postoperative delirium should be enough to prompt us all to make every possible effort for prevention.
https://t.co/0ngrbTXMyT

[Miles Berger @RealMilesBerger]

@NIDUS_Delirium @ANZDA_delirium @EDA_delirium @ASALifeline @ICU_delirium @DeliriumLmu @sharon_inouye @DukeSci_Soc @DukeMedSchool @dukemedicine @agedoc100 @MitchHeflin @MarieAngele20 @maloumeng @KamGhadimiMD @iars360 @ebmalinzakMD @asabcejo @TheBorisLab @BryanGlezerson

[Kahli Zietlow @KahliGoBlue]

Perioperative Optimization of Senior Health (POSH) improves postop outcomes for older adults. It's a proven model at @DukeGeriatrics and now successfully implemented at UTSW!

Congrats @swingfieldmd @agedoc100! #ThisisGeriatrics @AGSJournal

https://t.co/Pa1Y7VghQi

[Sarah Wingfield @swingfieldmd]

Important to move away from imprecise terms such as “altered mental status” - “delirium” is the clinical syndrome while “acute encephalopathy” describes the neuropathophysiology.

[Mark Oldham @MarkOldhamMD]

"The current unresolved tension between #delirium and acute #encephalopathy is more than word-deep and calls for a unified approach to the clinical syndrome and its underlying neuropathophysiology."

https://t.co/aNIpTjuZg1

@CL_Psychiatry @NIDUS_Delirium @AmerDelirium

[Kahli Zietlow @KahliGoBlue]

Geriatric pre-op evaluation can help patients clarify their goals, promote shared decision making, and may help reduce preventable cancellations.
Thanks @WorldJSurg for publishing our work examining surgical cancellations within @DukeGeriatrics #POSH

https://t.co/KX7RQSxJar

[Sharon Inouye, MD @sharon_inouye]

12 Unsettling Lessons Learned Trying To Make Healthcare Better ⁦@sacjai⁩ These resonate with me and are important truths for all trying time drive change in healthcare ⁦@ElderLifeProg⁩ https://t.co/h4nOVVoOpH

[HELP @ElderLifeProg]

COVID-19 is a #geriatric emergency, and we need to make sure we are protecting vulnerable older adults from #delirium in the ED during this time - please consider sharing this resource widely: https://t.co/PULiJ6Scpv @sharon_inouye @NIDUS_Delirium

[Shelley McDonald @agedoc100]

@AARP surgery that not just prolongs life but improves quality of life should also count as a success #geriatrics @JAMASurgery @Dukegeriatrics https://t.co/Lf3mTOWKht

[John @gothamgreyhound]

Reframing Surgical Risk Using Geriatric Assessment Measures https://t.co/8Z2en2YXkV

[HELP @ElderLifeProg]

Specific drugs that may exacerbate #delirium from @AmerGeriatrics Beers Criteria: anticholinergics (including some antidepressants, antiemetics, antihistamines), benzodiazepines, H2-receptor antagonists @sharon_inouye @NIDUS_Delirium #WDAD2020

[Shelley McDonald @agedoc100]

The ACE model of care provides benefit after emergency surgery in older adults with reduced complications, reduced LOS , and a greater proportion of patients returning directly home after surgery. https://t.co/wSHsD2y35w