Mortality associated with traumatic injuries in the elderly: A population based study
Mortality associated with traumatic injuries in the elderly: A population based study
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DOI：
10.1016/j.archger.2012.01.007
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发表时间：
2012-05-01
影响因子：
4
通讯作者：
Parks, Rowan W.
中科院分区：
文献类型：
--
作者：
O'Neill, Stephen;Brady, Richard R.;Parks, Rowan W.
老年人创伤的发病率正在增加，并与显着的发病率和死亡率。这项研究的主要目的是确定与老年人创伤后生存或死亡相关的因素。次要目的是比较老年人和年轻患者创伤的流行病学。对从苏格兰创伤审计小组（STAG）维护的前瞻性收集的多中心创伤数据库中获得的数据进行回顾性分析，该数据库包含11年期间25家参与苏格兰医院收治的52，887名创伤患者的详细信息。对老年创伤患者（年龄> 80岁）进行单独分析，并与年轻创伤患者（年龄13-80岁）进行比较。在确定的52，887例创伤患者中，4791例为老年人（9.1%）。老年患者在创伤后的绝对死亡率较高（9.9%对4%，p < 0.001）。在男性中，高跌倒后，格拉斯哥昏迷评分（GCS）较低，简明损伤评分（AIS）/损伤严重程度评分（ISS）较高，合并损伤，血流动力学受损和延迟就诊的老年人死亡率较高。多因素logistic回归分析证实，老年人死亡率与GCS低、男性、ISS高、脊髓损伤AIS高、血流动力学受损和伴随轻微腿部/手臂损伤之间存在独立关系。总之，老年患者的创伤与显著较高的死亡率相关。在老年人群中，低GCS、男性性别、较高ISS、较高AIS的脊柱损伤、血流动力学损害和伴随的轻微腿部/手臂损伤与创伤后死亡率具有最强的独立关系。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients. A retrospective analysis was performed of data that was obtained from a prospectively collected multi-centre trauma database maintained by The Scottish Trauma Audit Group (STAG) containing details of 52,887 trauma patients admitted to 25 participating Scottish Hospitals over an 11-year period. Elderly trauma patients (aged > 80 years) were separately analyzed and compared to younger trauma patients (aged 13-80). Of 52,887 trauma patients identified, 4791 were elderly (9.1%). Elderly patients had a higher absolute mortality rate following traumatic injury (9.9% versus 4%, p < 0.001). Mortality in the elderly was higher in males, following a high fall, with lower Glasgow Coma Scale (GCS), in those with higher Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS), in those with concomitant injuries, hemodynamic compromise and following delayed presentation. Multiple logistic regression analysis confirmed an independent relationship between mortality and low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) in the elderly. In conclusion, trauma in elderly patients is associated with significantly higher mortality. Low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) have the strongest independent relationships with mortality after trauma in the elderly population. (C) 2012 Elsevier Ireland Ltd. All rights reserved.