Emergency department and outpatient treatment of acute injuries in older adults in the United States: 2009-2010.
Emergency department and outpatient treatment of acute injuries in older adults in the United States: 2009-2010.
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DOI：
10.1111/jgs.12877
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发表时间：
2014-07
影响因子：
6.3
通讯作者：
Caterino JM
中科院分区：
文献类型：
--
作者：
Betz ME;Ginde AA;Southerland LT;Caterino JM
对老年人伤害的研究主要集中在住院治疗上，特别是在创伤中心，这可能导致对伤害负担的歪曲理解和低估。我们试图描述在美国急诊科和门诊初级保健环境中治疗的急性损伤的流行病学模式。对2009年和2010年全国卫生保健调查数据的回顾横断面分析。急诊室和门诊初级保健诊所。老年人(65岁≥)，首次因急性损伤就诊。按患者特征和护理环境划分的医疗伤害的频率和发生率。在2009-2010年间接受医疗护理的1,970万老年人急性损伤中，50%在急诊室接受治疗，50%在门诊初级保健诊所接受治疗。医疗伤害的年发病率随着年龄的增长而上升，从65岁至74岁的每百人20.8(95%可信区间=17.0-24.6)上升到≥85岁的每百人41.5(95%CI=33.5-49.4)。在与伤害相关的急诊室就诊中，60%发生在标准营业时间以外，36%被分类为“低视力”，25%导致入院。只有9%的伤害相关初级保健就诊记录了伤害预防咨询。医疗伤害发生在老年人中，发病率很高，并随着年龄的增长而增加。所有老年人急性损伤的首次就诊中，有一半是去初级保健诊所。大多数受伤的患者都出院了，但很少有关于伤害预防咨询的记录。为了给伤害预防工作提供适当的信息，避免低估伤害的负担，未来的伤害研究应该包括一系列的门诊和住院护理设置。
Studies of injury among older adults have primarily focused on hospitalizations, especially at trauma centers, which may result in a skewed understanding and underestimation of the burden of injury. We sought to describe epidemiologic patterns of acute injuries treated in both ED and outpatient primary care settings in the United States. Retrospective cross-sectional analysis of data from the 2009 and 2010 National Health Care Surveys. EDs and outpatient primary care clinics. Older adults (age ≥65) with initial visits for acute injuries. Frequencies and incidence rates of medically-attended injury by patient characteristics and care setting. Of the 19.7 million medically-attended acute injuries among older adults in 2009–2010, 50% were treated at EDs and 50% at outpatient primary care clinics. The annual incidence rate of medically-attended injuries rose with age, from 20.8 (95% Confidence Interval [CI]=17.0–24.6) per 100 among those aged 65 to 74 years up to 41.5 (95%CI=33.5–49.4) per 100 for those ≥85 years. Of injury-related ED visits, 60% occurred outside standard business hours, 36% were triaged as “low acuity,” and 25% resulted in admission. Only 9% of injury-related primary care visits had injury prevention counseling documented. Medically-attended injuries occur in older adults at high incidence and increase with advancing age. Half of all initial visits for acute injuries among older adults are to primary care clinics. Most injured patients are discharged home but injury prevention counseling is rarely documented. In order to appropriately inform injury prevention efforts and avoid underestimating the burden of injury, future injury studies should include a range of outpatient and inpatient care settings.
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影响因子：
3.7
作者：
Binder, S
通讯作者：
Binder, S
影响因子：
4
作者：
O'Neill, Stephen;Brady, Richard R.;Parks, Rowan W.
通讯作者：
Parks, Rowan W.
影响因子：
3.3
作者：
Jacobs, David G
通讯作者：
Jacobs, David G
影响因子：
2.3
作者：
Keller, Julie M.;Sciadini, Marcus F.;O'Toole, Robert V.
通讯作者：
O'Toole, Robert V.
影响因子：
4
作者：
Salter, AE;Khan, KM;McKay, HA
通讯作者：
McKay, HA