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Trabert J, Schenk A, Golbach R, Püllen R, Schütze S. Family-centered delirium prevention and treatment using video calls: the FACE Delirium trial. Eur Geriatr Med 2023; 14:1353-1357. [PMID: 37647011 PMCID: PMC10754740 DOI: 10.1007/s41999-023-00854-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE In the FACE Delirium trial, we investigated the feasibility of a structured FAmily-CEntered delirium prevention and treatment during the corona pandemic. METHODS Patients hospitalized in a German geriatric medicine department were included in this single-center, prospective, single-arm feasibility study. Their relatives received a short training on delirium and volunteers or paid staff members facilitated video calls. The primary endpoint was reached when contact between patients and their relatives occurred on ≥ 80% of treatment days, either via video call or visit. RESULTS 38 patients were included (age 83.0 ± 5.9 years; 73.7% women). 76.3% reached the primary endpoint. Due to the pandemic, 99.3% of the contacts were video calls with a duration of 24.8 ± 16.3 min. CONCLUSION Family-centered delirium prevention and treatment using video calls is feasible among hospitalized geriatric patients. Daily implementation in clinical practice poses challenges and requires motivated and qualified staff.
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Affiliation(s)
- Johannes Trabert
- Department of Geriatric Medicine, AGAPLESION Markus Hospital, Wilhelm-Epstein-Strasse 4, 60431, Frankfurt, Germany.
| | - Andreas Schenk
- Department of Geriatric Medicine, AGAPLESION Markus Hospital, Wilhelm-Epstein-Strasse 4, 60431, Frankfurt, Germany
| | - Rejane Golbach
- Institute for Biostatistics and Mathematic Modelling, Faculty of Medicine, Goethe-University, Frankfurt, Germany
| | - Rupert Püllen
- Department of Geriatric Medicine, AGAPLESION Markus Hospital, Wilhelm-Epstein-Strasse 4, 60431, Frankfurt, Germany
| | - Sandra Schütze
- Department of Geriatric Medicine, AGAPLESION Markus Hospital, Wilhelm-Epstein-Strasse 4, 60431, Frankfurt, Germany
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2023; 56:703-705. [PMID: 37861730 DOI: 10.1007/s00391-023-02254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Rupert Püllen
- AGAPLESION MARKUS KRANKENHAUS, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2023; 56:516-517. [PMID: 37491645 DOI: 10.1007/s00391-023-02224-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Rupert Püllen
- Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt/Main, Deutschland.
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2023:10.1007/s00391-023-02192-1. [PMID: 37142811 DOI: 10.1007/s00391-023-02192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.
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Püllen R. [Deprescribing in nursing homes - which drugs and when?]. MMW Fortschr Med 2023; 165:38-41. [PMID: 36826665 DOI: 10.1007/s15006-023-2316-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Deutschland.
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Rübsam M, Püllen R, Telkamp F, Bianco A, Pescoller M, Bloch W, Green K, Merkel R, Hoffmann B, Wickström S, Niessen C. 185 aPKC is a rheostat that controls basal junctional dynamics and suprabasal cytoskeletal organization essential for epidermal dynamics and integrity. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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7
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2022; 55:531-532. [PMID: 35768730 DOI: 10.1007/s00391-022-02081-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rupert Püllen
- AGAPLESION MARKUS KRANKENHAUS, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Deutschland.
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Ollenschläger M, Kluge F, Müller-Schulz M, Püllen R, Möller C, Klucken J, Eskofier BM. Correction to: Wearable gait analysis systems: ready to be used by medical practitioners in geriatric wards? Eur Geriatr Med 2022; 13:825-826. [PMID: 35414052 PMCID: PMC9378333 DOI: 10.1007/s41999-022-00646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Malte Ollenschläger
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Carl-Thiersch-Str. 2b, 91052, Erlangen, Germany.
| | - Felix Kluge
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Carl-Thiersch-Str. 2b, 91052, Erlangen, Germany
| | | | - Rupert Püllen
- AGAPLESION MARKUS KRANKENHAUS, Frankfurt am Main, Germany
| | | | - Jochen Klucken
- Centre Hospitalier de Luxembourg, Luxembourg Institute of Health, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Carl-Thiersch-Str. 2b, 91052, Erlangen, Germany
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2022; 55:165-167. [PMID: 34985582 DOI: 10.1007/s00391-021-02001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.
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Dovjak P, Püllen R. [Journal club]. Z Gerontol Geriatr 2021; 54:833-835. [PMID: 34714409 DOI: 10.1007/s00391-021-01973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Peter Dovjak
- Oberösterreichische Gesundheitsholding GmbH, Salzkammergut Klinikum, Bad Ischl.Gmunden.Vöcklabruck, Miller-von-Aichholz-Str. 49, 4810, Gmunden, Österreich.
| | - Rupert Püllen
- AGAPLESION FrankfurterDiakonie Kliniken, Frankfurt/Main, Deutschland
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2021; 54:621-622. [PMID: 34223983 DOI: 10.1007/s00391-021-01937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Deutschland.
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2021; 54:409-411. [PMID: 33728517 PMCID: PMC7962923 DOI: 10.1007/s00391-021-01875-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, AGAPLESION FRANKFURTER DIAKONIE KLINIKEN gemeinnützige GmbH, Ginnheimer Landstraße 94, 60487, Frankfurt am Main, Deutschland.
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Püllen R. [Journal Club]. Z Gerontol Geriatr 2020; 54:176-177. [PMID: 33346881 DOI: 10.1007/s00391-020-01832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Rupert Püllen
- Medizinisch-Geriatrische Klinik, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Straße 4, 60431, Frankfurt/Main, Deutschland.
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Püllen R. Journal Club. Z Gerontol Geriatr 2020; 53:357-358. [DOI: 10.1007/s00391-020-01721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Püllen R. Journal Club. Z Gerontol Geriatr 2020; 53:75-77. [DOI: 10.1007/s00391-019-01677-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Püllen R. Journal Club. Z Gerontol Geriatr 2019; 52:503-504. [DOI: 10.1007/s00391-019-01575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Affiliation(s)
- R Püllen
- Agaplesion Frankfurter Diakonie-Kliniken, Holzhausenstr. 72-92, 60322, Frankfurt/Main, Deutschland.
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Püllen R. [Secondary prophylaxis after fractures is deficient]. Z Gerontol Geriatr 2016; 50:86. [PMID: 27981348 DOI: 10.1007/s00391-016-1164-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R Püllen
- Agaplesion Frankfurter Diakonie-Kliniken, Holzhausenstr. 72-92, 60322, Frankfurt a. M., Deutschland.
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Singler K, Dormann H, Dodt C, Heppner HJ, Püllen R, Burkhardt H, Swoboda W, Roller-Wirnsberger RE, Pinter G, Mrak P, Münzer T. Erratum zu: Der geriatrische Patient in der Notaufnahme. Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Püllen R. [Mobility in hospital]. Z Gerontol Geriatr 2016; 49:664-665. [PMID: 27599817 DOI: 10.1007/s00391-016-1131-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rupert Püllen
- Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt a. M., Deutschland.
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Singler K, Dormann H, Dodt C, Heppner HJ, Püllen R, Burkhardt M, Swoboda W, Roller-Wirnsberger RE, Pinter G, Mrak P, Münzer T. Der geriatrische Patient in der Notaufnahme. Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0216-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dovjak P, Püllen R. Journal Club. Z Gerontol Geriatr 2016; 49:455-7. [DOI: 10.1007/s00391-016-1086-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dovjak P, Püllen R. Erratum zu: Journal Club. Z Gerontol Geriatr 2016; 49:260-1. [DOI: 10.1007/s00391-016-1059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2015. [DOI: 10.1007/s00391-015-0994-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2015. [DOI: 10.1007/s00391-015-0975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2015. [DOI: 10.1007/s00391-015-0859-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2014. [DOI: 10.1007/s00391-014-0815-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2014. [DOI: 10.1007/s00391-014-0631-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2014. [DOI: 10.1007/s00391-014-0623-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2013. [DOI: 10.1007/s00391-013-0548-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Püllen R, Laupheimer U, Hermann E. Predictors for falls in elderly hospital patients. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Püllen R, Dovjak P, Kolb GF. Journal Club. Z Gerontol Geriatr 2013. [DOI: 10.1007/s00391-013-0517-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2013. [DOI: 10.1007/s00391-013-0495-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2013. [DOI: 10.1007/s00391-012-0466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2012. [DOI: 10.1007/s00391-012-0379-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Püllen R, Dovjak P. [Journal club]. Z Gerontol Geriatr 2012; 45:673-4. [PMID: 23052284 DOI: 10.1007/s00391-012-0378-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R Püllen
- Agaplesion Frankfurter Diakonie-Kliniken, Holzhausenstr. 72-92, 60322, Frankfurt am Main, Deutschland.
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Püllen R, Dovjak P. Journal Club. Z Gerontol Geriatr 2012. [DOI: 10.1007/s00391-012-0317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Püllen R, Anhold M. [Pressure ulcers: prevention and treatment]. MMW Fortschr Med 2011; 153:80-84. [PMID: 21977801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Rupert Püllen
- Chefarzt Medizinisch-Geriatrische Klinik, AGAPLESION Diakonissen und Markus Krankenhaus, Medizinisch-Geriatrische Klinik Frankfurt am Main.
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Püllen R. [Not Available]. MMW Fortschr Med 2011; 153:80-84. [PMID: 27388320 DOI: 10.1007/bf03371836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Rupert Püllen
- AGAPLESION Diakonissen und Markus Krankenhaus Medizinisch-Geriatrische Klinik, Holzhausenstr. 72-92, D-60322, Frankfurt/M., Deutschland.
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Rösler A, Hofmann W, von Renteln-Kruse W, Flesch P, Greuel HW, Hoffmann J, Hofmann W, Kopf D, Meyer AK, Merk B, Nehen HG, Püllen R, Schwab J, von Renteln-Kruse W, Weil K. [Special care units for the treatment of acutely ill, cognitively impaired geriatric patients in Germany]. Z Gerontol Geriatr 2011; 43:249-53. [PMID: 20848262 DOI: 10.1007/s00391-010-0132-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
During recent years, specialized wards have been established in geriatric hospital departments as a consequence of the growing need of special care for acutely ill older patients, who are also cognitively impaired. However, there are neither established standards nor any commonly agreed concept of care. A written survey among 12 specialized wards in Germany revealed some characteristics of these wards: extended geriatric assessment, special education of staff including validation and gerontopsychiatric issues, and particular equipment/architecture, such as hidden doors and group rooms, and in some cases loop tracks for walking, therapeutic facilities, and 'living rooms' on the wards. There is a wide variability with respect to the designation of these wards, the number of beds, length of stay, and admission criteria. It appears from this survey that there should be an exchange of empirical experience made on these wards, and there is a need of collaborative research on its usefulness.
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Affiliation(s)
- A Rösler
- Medizinisch-Geriatrische Klinik, Albertinen-Haus, Zentrum für Geriatrie und Gerontologie, Wissenschaftliche Einrichtung an der Universität Hamburg, Sellhopsweg 18-22, 22459 Hamburg.
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Abstract
The treatment of pressure sores in elderly patients requires careful documentation and a comprehensive treatment plan, which takes into account the patient's overall situation. The treatment has to be evidence based. At the moment only three recommendations can be based on two or more prospective, randomized clinical studies: to use a dressing to maintain a moist environment at the wound/dressing interface, to reduce the risk of infection and enhance wound healing by hand washing, wound cleansing and debridement and to institute a systemic antibiotic treatment for patients with advancing cellulitis, sepsis and osteomyelitis. For other treatment options such as topical negative pressure, maggot therapy, electromagnetic therapy, therapeutic ultrasound or growth factors, the data at present are not sufficient to support general use in pressure sore treatment.
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Affiliation(s)
- R Püllen
- Medizinisch-geriatrische Klinik, Diakonissen-Krankenhaus Frankfurter Diakonie-Kliniken, Holzhausenstrasse 72-92, 60322 Frankfurt/Main, Germany.
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Püllen R, Popp R, Volkers P, Füsgen I. Prospective randomized double-blind study of the wound-debriding effects of collagenase and fibrinolysin/deoxyribonuclease in pressure ulcers. Age Ageing 2002; 31:126-30. [PMID: 11937475 DOI: 10.1093/ageing/31.2.126] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND proteolytic enzymes such as collagenase, fibrinolysin and deoxyribonuclease are used for debriding purulent or fibrinous pressure ulcers. OBJECTIVE to test the hypothesis that collagenase debrides necrotic pressure ulcers more effectively than fibrinolysin/deoxyribonuclease. METHODS we enrolled 135 elderly patients with pressure ulcers in a randomized, prospective double-blind trial. Patients were treated until complete wound debridement or for a maximum of 4 weeks with twice-daily applications of collagenase or fibrinolysin/deoxyribonuclease. The primary endpoint was percentage change in the yellow or black wound surface. Secondary endpoints were wound environment, margins, depth, pocketing, area and healing. Assessment was by two independent dermatologists who were unaware of the treatment administered and evaluated results from photographs taken at the beginning and end of treatment. RESULTS on intention-to-treat analysis, collagenase gave slightly better results with regard to the primary endpoint in the 121 assessable patients, but this difference was not statistically significant (P=0.115). Additional efficacy measures did not show any statistically significant difference between the groups. CONCLUSION there was no evidence of a difference between collagenase and fibrinolysin/deoxyribonuclease in the debridement of pressure ulcers.
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Affiliation(s)
- Rupert Püllen
- Geriatrische Kliniken St Antonius, University Witten/Herdecke, Hardtstrasse 46, 42107 Wuppertal, Germany.
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Püllen R, Heikaus C. [Decubitus ulcer in the hospital. Assessment for quality assurance?]. Krankenpfl J 2002; 40:144-7. [PMID: 12271494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Abstract
The further development of 162 stroke patients (average age 77 years), who were geriatrically assessed during hospitalization, was evaluated ca. 18 months after stroke. Questionnaires were mailed to patients. 53% of the patients (n = 86) returned the questionnaire duly filled in; 20% (n = 32) had died; in the remaining 27% of cases (n = 44) no information was obtained on further development. 80% of those patients who responded lived at home despite numerous medical problems. Family members assumed most of the care required. Follow-up treatment and pain therapy proved to be particularly problematic. The Barthel Index according to data collected was significantly lower compared to figures noted upon release from the hospital. Hardly anyone among those patients received follow-up treatment. 74% of patients complained of pain although the majority has regular contacts with the family doctor. For those patients who died in the 18 months interval, significantly lower values for the activities of daily living (ADL) has already been recorded upon hospitalization. They had a less favorable view of their state of health and were less satisfied with life in general.
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Affiliation(s)
- R Püllen
- 3. Med. Klinik der Kliniken St. Antonius, Geriatrische Klinik für die Universität Witten/Herdecke, Tönisheider Str.24, D-42553 Velbert
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Püllen R. [Psychotropic drugs and automobile driving ability of elderly patients]. Versicherungsmedizin 1999; 51:71-4. [PMID: 10420837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Many elderly patients are prescribed psychotropic medication, many of them are car drivers. Driving ability may be impaired by the underlying psychiatric disease, the medication or the combination of both. Psychoactive medications do not all influence driving ability to the same extent. Cyclic antidepressants impair driving performance to a higher degree than selective serotonin reuptake inhibitors (SSRI) or MAO inhibitors. In cases of severe psychiatric diseases like major depression an appropriate psychoactive medication may improve driving performance. The influence of psychoactive drugs on driving ability is not always taken into account. There are no data available that allow a reliable assessment of these drugs in elderly patients. To meet the challenge of this problem, patients and doctors have to be aware of this problem; studies about the impact of psychoactive drugs on driving ability are necessary.
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Affiliation(s)
- R Püllen
- III. Med. Klinik der Kliniken St. Antonius, Geriatrische Klinik für die Universität Witten/Herdecke, Velbert
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Füsgen I, Bienstein C, Böhmer F, Busch B, Cottenden A, Heidler H, Scherr A, Püllen R. Interdisciplinary care of urinary incontinence in the elderly. World J Urol 1998; 16 Suppl 1:S62-70. [PMID: 9775417 DOI: 10.1007/pl00014140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- I Füsgen
- Lehrstuhl für Geriatrie, Universität Witten/Herdecke, Germany
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