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dc.contributor.authorJohnston, C. Bree
dc.contributor.authorHolleran, Amanda
dc.contributor.authorOng, Thuan
dc.contributor.authorMcVeigh, Ursula
dc.contributor.authorAmes, Elizabeth
dc.date.accessioned2018-10-08T22:10:43Z
dc.date.available2018-10-08T22:10:43Z
dc.date.issued2018
dc.identifier.citationC. Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, and Elizabeth Ames. Journal of Palliative Medicine. Aug 2018. http://doi.org/10.1089/jpm.2018.0029en_US
dc.identifier.issn1096-6218
dc.identifier.issn1557-7740
dc.identifier.pmid29792735
dc.identifier.doi10.1089/jpm.2018.0029
dc.identifier.urihttp://hdl.handle.net/10150/630099
dc.description.abstractImportance: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. Observation: Goals of care discussions appear to be rare in the setting of fragility fracture. The urgent nature of the problem makes such discussions challenging. We believe that many physicians have not considered goals of care discussions to be a standard component of fragility fracture management. Conclusions: We propose that physicians caring for patients with limited life expectancy and fragility fracture of the hip should initiate a goals of care discussion to help determine whether operative repair will be the most patient-centered approach. Training on conducting goals of care discussions should be a standard part of surgical training programs. Goals of care discussions should include prognosis, patient values and preferences, pain, likelihood for functional recovery, and burdens and benefits of surgical versus nonsurgical management. Multidisciplinary input is required, and many patients will benefit from geriatric and/or palliative care team involvement.en_US
dc.language.isoenen_US
dc.publisherMARY ANN LIEBERT, INCen_US
dc.relation.urlhttp://www.liebertpub.com/doi/10.1089/jpm.2018.0029en_US
dc.rightsCopyright © 2018, Mary Ann Liebert, Inc.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectgoals of careen_US
dc.subjecthip fractureen_US
dc.subjectlimited life expectancyen_US
dc.titleHip Fracture in the Setting of Limited Life Expectancy: The Importance of Considering Goals of Care and Prognosisen_US
dc.typeArticleen_US
dc.contributor.departmentUniv Arizona, Coll Med, Dept Meden_US
dc.identifier.journalJOURNAL OF PALLIATIVE MEDICINEen_US
dc.description.note12 month embargo; published online: 1 August 2018en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.source.journaltitleJournal of Palliative Medicine
dc.source.volume21
dc.source.issue8
dc.source.beginpage1069
dc.source.endpage1073


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