Publications by authors named "Ole Martin Steihaug"

8 Publications

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Severe Neurological Sequelae after a Recreational Dose of LSD.

J Anal Toxicol 2020 Oct 8. Epub 2020 Oct 8.

Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim.

A young man with an unremarkable medical history suffered a seizure with subsequent cardiorespiratory arrest and severe neurological sequelae after ingesting a blotter. Analysis of a similar blotter and a serum sample obtained 3 hours after the event detected lysergic acid diethylamide (LSD) at the amount of 300 μg in the blotter and at a concentration of 4.0 ng/mL (12.4 nmoles/L) in serum. No other drugs were present in concentrations which may confer significant effects. In addition, no individual traits which would make the patient particularly susceptible to adverse LSD effects have subsequently been identified. This suggests that LSD may confer toxic effects in previously healthy individuals.
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http://dx.doi.org/10.1093/jat/bkaa145DOI Listing
October 2020

Cognitive impairment influences the risk of reoperation after hip fracture surgery: results of 87,573 operations reported to the Norwegian Hip Fracture Register.

Acta Orthop 2020 04 13;91(2):146-151. Epub 2020 Jan 13.

Norwegian Hip Fracture Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen.

Background and purpose - About one-fourth of hip fracture patients have cognitive impairment. We investigated whether patients' cognitive function affects surgical treatment, risk of reoperation, and mortality after hip fracture, based on data in the Norwegian Hip Fracture Register (NHFR).Patients and methods - This prospective cohort study included 87,573 hip fractures reported to the NHFR in 2005-2017. Hazard rate ratios (HRRs) for risk of reoperation and mortality were calculated using Cox regression adjusted for sex, age, ASA class, fracture type, and surgical method.Results - Cognitive impairment was reported in 27% of patients. They were older (86 vs. 82 years) and had higher ASA class than non-impaired patients. There were no differences in fracture type or operation methods. Cognitively impaired patients had a lower overall reoperation rate (4.7% vs. 8.9%, HRR 0.71; 95% CI 0.66-0.76) and lower risk of reoperation after osteosynthesis (HRR 0.58; CI 0.53-0.63) than non-impaired patients. Cognitively impaired hip fracture patients had an increased reoperation risk after hemiarthroplasty (HRR 1.2; CI 1.1-1.4), mainly due to dislocations (1.5% vs. 1.0%, HRR 1.7; CI 1.3-2.1). Risk of dislocation was particularly high following the posterior approach (4.7% vs. 2.8%, HRR 1.8; CI 1.2-2.7). Further, they had a higher risk of reoperation due to periprosthetic fracture after uncemented hemiarthroplasty (HRR 1.6; CI 1.0-2.6). Cognitively impaired hip fracture patients had higher 1-year mortality than those without cognitive impairment (38% vs. 16%, HRR 2.1; CI 2.1-2.2).Interpretation - Our findings support giving cognitively impaired patients the same surgical treatment as non-impaired patients. But since the risk of hemiprosthesis dislocation and periprosthetic fracture was higher in cognitively impaired patients, they should probably not have posterior approach surgery or uncemented implants.
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http://dx.doi.org/10.1080/17453674.2019.1709712DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144309PMC
April 2020

Validation of orthopaedic surgeons' assessment of cognitive function in patients with acute hip fracture.

BMC Musculoskelet Disord 2019 Jun 1;20(1):268. Epub 2019 Jun 1.

Norwegian Hip Fracture Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Jonas Lies vei 65, N 5021, Bergen, Norway.

Background: About one fourth of patients with hip fracture have cognitive impairment. These patients are at higher risk of surgical and medical complications and are often excluded from participating in clinical research. The aim of the present study was to investigate orthopaedic surgeons' ability to determine the cognitive status of patients with acute hip fracture and to compare the treatment given to patients with and without cognitive impairment.

Methods: The cognitive function of 1474 hip fracture patients reported by the orthopaedic surgeons to the nationwide Norwegian Hip Fracture Register was compared with data registered in quality databases in two hospitals with orthogeriatric service on the same patients. Cognitive function registered in the quality databases was determined either by the short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) or by pre-fracture diagnosis of dementia. The information registered in the quality databases was defined as the reference standard. Cognitive function in the Norwegian Hip Fracture Register was reported as: Chronic cognitive impairment? "Yes", "Uncertain" or "No" by the orthopaedic surgeons. Sensitivity, specificity, negative and positive predictive values for chronic cognitive impairment reported to the Norwegian Hip Fracture Register by the orthopaedic surgeons was calculated. Baseline data and treatment of hip fractures in patients with and without cognitive impairment in the Norwegian Hip Fracture Register were compared.

Results: Orthopaedic surgeons reported chronic cognitive impairment in 31% of the patients. Using documented dementia or IQCODE > 4.0 as the reference, this assessment of cognitive impairment by the orthopaedic surgeons had a sensitivity of 69%, a specificity of 90%, a positive predictive value of 78%, and a negative predictive value of 84% compared to information registered in the two hospital quality databases. There were no differences in type of hip fracture or type of surgical treatment by cognitive function.

Conclusion: The treatment of hip fractures was similar in patients with chronic cognitive impairment and cognitively well-functioning patients. The surgeons had an acceptable ability to identify and report chronic cognitive impairment in the peri-operative period, indicating that the Norwegian Hip Fracture Register is a valuable resource for future registry-based research also on hip fracture patients with chronic cognitive impairment.
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http://dx.doi.org/10.1186/s12891-019-2633-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545206PMC
June 2019

Does sarcopenia predict change in mobility after hip fracture? a multicenter observational study with one-year follow-up.

BMC Geriatr 2018 03 5;18(1):65. Epub 2018 Mar 5.

Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway.

Background: Patients with hip fracture frequently have sarcopenia and are at great risk of loss of mobility. We have investigated if sarcopenia predicts change in mobility after hip fracture.

Methods: This is a prospective, multicenter observational study with one-year follow-up. Patients with hip fracture who were community-living and capable of walking before the fracture were included at three hospitals in Norway (2011-2013). The primary outcome of the study was change in mobility, measured by the New Mobility Score (NMS). Sarcopenia was determined postoperatively by anthropometry, grip strength, and NMS.

Results: We included 282 participants and sarcopenia status was determined in 201, of whom 38% (77/201) had sarcopenia, 66% (128/194) had low muscle mass, 52% (116/222) had low grip strength and 8% (20/244) had low pre-fracture mobility (NMS < 5). Sarcopenia did not predict change in mobility (effect 0.2 points; 95% CI -0.5 to 0.9, P = 0.6), but it was associated with having lower mobility at one-year (NMS 5.8 (SD 2.3) vs. 6.8 (SD 2.2), P = 0.003), becoming a resident of a nursing home (odds ratio 3.2, 95% CI 0.9 to 12.4, P = 0.048), and the combined endpoint of becoming a resident of a skilled nursing home or death (odds ratio 3.6, 95% CI 1.2 to 12.2, P = 0.02).

Conclusions: Sarcopenia did not predict change in mobility in the year after hip fracture.
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http://dx.doi.org/10.1186/s12877-018-0755-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836393PMC
March 2018

Reduced Walking Speed in Subjective and Mild Cognitive Impairment: A Cross-Sectional Study.

J Geriatr Phys Ther 2019 Jul/Sep;42(3):E122-E128

Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.

Background And Purpose: Walking speed is reduced in people with dementia, but less is known about predementia conditions. We, therefore, studied the relationship between walking speed, cognition, and cerebrospinal fluid biomarkers in persons with subjective (SCI) and mild cognitive impairment (MCI).

Methods: We conducted a cross-sectional study of 22 healthy controls, 30 SCI and 17 MCI (N = 69). Walking speed was measured by a 10-m gait test at usual and fast pace. We analyzed the association between walking speed and the ordered categories of controls, SCI, and MCI in a generalized proportional odds model. Neuropsychological tests, Consortium to Establish a Registry for Alzheimer's Disease (delayed recall), and Trail Making (TMT) A and B, were analyzed by negative binomial, linear, and robust regression for association with walking speed.

Results: Walking speed at usual pace was slower moving from controls to SCI (odds ratio: 0.46, P = 0.031) and MCI (odds ratio: 0.44, P = .019) on an ordinal scale. In MCI, walking speed was reduced at fast speed (odds ratio: 0.46, P = 0.04). There were significant associations between walking speeds and neuropsychological test performance. Usual walking speed was associated with slower test performance on TMT-A (β: -.02, P = .04) and fast pace with slower performance on TMT-B (β: -.01, P = .03). There were no associations between cerebrospinal fluid biomarkers and walking speeds.

Conclusion: Usual walking speed is reduced in a graded fashion with the early symptoms of cognitive impairment. Our results suggest that reduced walking speed at both usual and fast speed is associated with impaired cognitive function, and that walking speed could be affected at very early stages of neurodegeneration.
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http://dx.doi.org/10.1519/JPT.0000000000000157DOI Listing
April 2020

Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

PLoS One 2017 13;12(9):e0184780. Epub 2017 Sep 13.

Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway.

Background: Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities.

Methods: A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score.

Results: Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0].

Conclusions: Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184780PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597226PMC
October 2017

[Re: The Norwegian Care Coordination Reform--what now?].

Tidsskr Nor Laegeforen 2015 Nov 3;135(20):1814. Epub 2015 Nov 3.

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http://dx.doi.org/10.4045/tidsskr.15.1069DOI Listing
November 2015

[Difficulties to sleep--too much hypnotics].

Tidsskr Nor Laegeforen 2013 Oct;133(20):2118

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http://dx.doi.org/10.4045/tidsskr.13.1178DOI Listing
October 2013