Special considerations in geriatric injury.
Special considerations in geriatric injury.
复制标题
DOI：
10.1097/00075198-200312000-00012
复制
发表时间：
2003-12-01
影响因子：
3.3
通讯作者：
Jacobs, David G
中科院分区：
文献类型：
--
作者：
Jacobs, David G
审查目的：随着老年人口的扩大和采用越来越积极的生活方式，创伤和重症监护医生将面临为更多的严重受伤患者提供护理。然而，由于其相关的预先存在的医疗条件和相对较差的生理储备，老年患者有较高的死亡率和较差的长期功能的结果比年轻的同行。一个彻底的了解这些不同的结果的原因是至关重要的，如果成功的策略和治疗，这一独特的患者population.Recent发现：目前可用的老年创伤文献主要是描述性和回顾性的，并没有提供准备好的解释或解决方案，这一患者群体经历的严重后果。通过在指定的创伤中心提供早期和积极的护理，结果确实有所改善，但分流不足仍然是一个重大问题。建议早期入住ICU，但其益处尚未得到证实。老年人和年轻患者之间存在显着差异的损伤模式，并在频率和类型的并发症这些差异反过来要求及时的诊断方法，积极的治疗，和独特的预防strategies.SUMMARY：具有讽刺意味的是，该领域的老年创伤仍处于起步阶段。考虑到高龄、相关既存疾病和生理储备不足之间的关系，老年患者就诊时结局不佳可能是不可避免的。因此，应更加重视这一患者人群的伤害预防工作。迫切需要在老年创伤方面进行设计良好的前瞻性研究。
PURPOSE OF REVIEW: As the elderly population expands and adopts increasingly more active lifestyles, trauma and critical care practitioners will be faced with providing care for greater numbers of severely injured patients. However, because of their associated preexisting medical conditions and poor relative physiologic reserve, geriatric patients have higher mortality rates and poorer long-term functional outcomes than their younger counterparts. A thorough understanding of the causes for these disparate outcomes is critical if successful strategies and treatments for this unique patient population are to be developed.RECENT FINDINGS: The currently available geriatric trauma literature is largely descriptive and retrospective, and does not provide ready explanations or solutions for the substantially worse outcomes experienced by this patient population. It does appear that outcomes are improved by providing early and aggressive care in designated trauma centers, yet undertriage remains a significant problem. Early admission to an ICU has been recommended, but its benefits remain unproved. Significant differences exist between older and younger patients in injury patterns, and in the frequency and type of complications These differences in turn demand prompt diagnostic approaches, aggressive treatment, and unique prevention strategies.SUMMARY: Ironically, the field of geriatric trauma is still in its infancy. Given the relation between advanced age, associated preexisting medical conditions, and poor physiologic reserve, a poor outcome may be inevitable by the time the geriatric patient presents for medical attention. Greater emphasis should therefore be placed on injury prevention efforts in this patient population. There is a dire need for well-designed prospective studies in geriatric trauma.