The Impact of Discharging Minimally Injured Trauma Patient: Does Age Play a Role in Trauma Admission?
The Impact of Discharging Minimally Injured Trauma Patient: Does Age Play a Role in Trauma Admission?
复制标题
DOI：
10.1097/ta.0b013e31821693e2
复制
发表时间：
2011-06-01
影响因子：
--
通讯作者：
Brasel, Karen
中科院分区：
文献类型：
--
作者：
Peschman, Jacob;Neideen, Todd;Brasel, Karen
背景资料：年龄被建议作为转移到创伤中心的分类标准，尽管无论创伤中心级别如何，类似损伤后的结果都很差。根据年龄对创伤中心进行分类的效果尚未得到评估。我们假设老年患者的入院率与其他成人创伤人群相比会有差异，与损伤严重程度无关。方法：回顾了1,970例成人患者的记录，这些患者由创伤团队在I级创伤中心评估，并直接从急诊科出院。数据提取包括人口统计学、损伤和生理信息。这些数据与同期收治的3，232名创伤患者进行了比较，这些患者通过记录审查获得了类似的信息。对老年患者的入院率进行χ（2）分析，然后进行二项logistic回归以确定影响入院几率的因素。结果：共有451例（8.68%）患者年龄≥ 65岁，占总人口的62.2%。入院的老年患者明显更多（82%）（chi（2）= 126.24; p < 0.001）。多因素分析显示，年龄、头部损伤、损伤严重程度评分、格拉斯哥昏迷评分和初始血压是预测入院的重要独立因素（p < 0.001）。结论：年龄单独与入院几率增加相关，与损伤严重程度和其他生理参数无关。这对创伤中心和创伤系统都有影响，创伤中心的老年创伤患者占很大比例，创伤系统必须为“美国老龄化”做好准备。"
Background: Age is suggested as a triage criteria for transfer to a trauma center, despite poor outcomes after similar injury regardless of trauma center level. The effect of differential triage based on age to a trauma center has not been evaluated. We hypothesized that there would be a difference in the admission rates of geriatric patients compared with the rest of the adult trauma population independent of injury severity.Methods: Records of 1,970 adult patients evaluated by the trauma team at a Level I trauma center and discharged directly from the emergency department were reviewed. Data abstracted included demographics, injuries, and physiologic information. These data were compared with 3,232 trauma patients admitted over the same time period who had similar information abstracted via record review. chi(2) analysis of the admission rates of geriatric patients was performed, followed by a binomial logistic regression to determine factors that affected the odds of admission.Results: A total of 451 (8.68%) patients were 65 years or older; 62.2% of the total population was admitted. Significantly more geriatric patients (82%) were admitted (chi(2) = 126.24; p < 0.001). Multivariate analysis showed that age, head injury, Injury Severity Score, Glasgow Coma Scale, and initial blood pressure were significant independent factors in predicting hospital admission (p < 0.001).Conclusions: Age alone is associated with increased odds of being admitted to the hospital, independent of injury severity and other physiologic parameters. This has implications for trauma centers that see a significant proportion of geriatric trauma patients and for trauma systems that must prepare for the "aging of America."