Geriatric falls: Injury severity is high and disproportionate to mechanism
Geriatric falls: Injury severity is high and disproportionate to mechanism
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DOI：
10.1097/00005373-200101000-00021
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发表时间：
2001-01-01
影响因子：
--
通讯作者：
Bonadies, J
中科院分区：
文献类型：
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作者：
Sterling, DA;O'Connor, JA;Bonadies, J
目的：福尔斯是老年人发病率和死亡率的一个众所周知的来源，然而，这一组中与Pall相关的损伤严重程度尚不清楚，特别是与跌倒类型相关。我们的目的是探讨老年患者跌倒的机制和损伤的模式和严重程度之间的关系，与年轻coherent.Methods相比：我们的创伤注册表查询了412年（1994-1998）期间的创伤服务评估的所有患者。根据年龄大于65岁或小于或等于65岁形成两个队列，并比较其机制、损伤严重程度评分（TSS）、简化损伤量表评分和mortality.Results：在研究期间，对1,512例患者进行了评价，其中333例大于65岁，1,179例小于或等于65岁。福尔斯是老年组48%和年轻组7%的损伤机制（p < 0.05），老年组福尔斯占ISS > 15的患者的65%，所有福尔斯中有32%导致严重损伤（ISS > 15）。相比之下，年轻组的福尔斯跌倒仅占ISS >15患者的11%，福尔斯跌倒造成严重损伤的时间仅为15（均p < 0.05），值得注意的是，老年组中相同高度的福尔斯跌倒导致严重损伤的概率为30%，而年轻组为4%（p < 0.05），并且在老年组中负责ISS >15 - 30倍（31% vs. < 1%; p < 0.05），简化损伤量表评估显示，（47% vs. 22%，胸部（23% vs. 9%）和骨盆/四肢（27%对15%）老年组的所有福尔斯跌倒损伤老年组同水平福尔斯平均ISS下降，是青年组的2倍（9.28 vs. 4.64，p < 0.05），而在老年组本身中，多水平和同水平福尔斯之间的平均LSS没有差异（10.12 vs. 9.28，p > 0.05，顺序组中跌倒相关死亡率较高（7% vs. 4%），与年轻人相比，福尔斯的死亡率高出7倍（55% vs. 7.5%）（均p < 0.05），老年人中，同水平福尔斯跌倒作为死亡原因的常见率是老年人的10倍（25% vs. 2.5%，p < 0.05），结论：老年人中的福尔斯，包括同高度的福尔斯，是高损伤严重性和死亡率的常见来源，比年轻患者更严重，老年和年轻跌倒患者之间也存在不同的损伤模式。
Objective: Falls are a well-known source of morbidity and mortality in the elderly, Pall-related injury severity in this group, however, is less clear, particularly as it relates to type of fall. Our purpose is to explore the relationship between mechanism of fall and both pattern and severity of injury in geriatric patients as compared with a younger cohort.Methods: Our trauma registry was queried for all patients evaluated by the trauma sen ice over a 412-year period (1994-1998). Two cohorts were formed on the basis of age greater than 65 or less than or equal to 65 years and compared as to mechanism, Injury Severity Score (TSS), Abbreviated Injury Scale score, and mortality.Results: Over the study period, 1,512 patients were evaluated, 333 greater than 65 years and 1,179 less than or equal to 65 years of age. Falls were the injury mechanism in 48% of the older group and 7% of the younger group (p < 0.05), Falls in the older group constituted 65% of patients with ISS > 15, with 32% of all falls resulting in serious injury (ISS > 15). In contrast, falls in the younger group constituted only 11 % of ISS >15 patients, with falls causing serious injury only 15 % of the time (both p < 0.05), Notably, same-level falls resulted in serious injury 30% of the time in the older group versus 4% in the younger group (p < 0.05), and were responsible for an ISS >15 30-fold more in the older group (31% vs. < 1%; p < 0.05), Abbreviated Injury Scale evaluation revealed more frequent head/neck (47% vs. 22%, chest (23% vs. 9%), and pelvic/ extremity (27% vs, 15%) injuries in the older group for all falls (all p < 0.05), The mean ISS for same-level falls in the older group,vas twice that for the younger group (9.28 vs. 4.64, p < 0.05), whereas there was no difference in mean LSS between multilevel and same-level falls within the older group itself (10.12 vs. 9.28, p > 0.05, The Fall-related death rate was higher in the order group (7% vs. 4%), with falls seven times more likely to be the cause of death compared with the younger group (55% vs. 7.5%) (both p < 0.05), Same-level falls as a cause of death was 10 times more common in the elderly (25% vs. 2.5%, p < 0.05),Conclusion: Falls among the elderly, including same-level falls, are a common source of both high injury severity and mortality, much more so than in younger patients, A different pattern of injury between older and younger fall patients also exists.