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Outcomes of admitted geriatric trauma victims.
Am J Emerg Med. 2000 Sep; 18(5):575-80.AJ

Abstract

Conflicting data exist as to the outcome of elderly victims of trauma. With recent improved outcomes for functional recovery, aggressive management of these patients has been advocated. The purpose of this study is to determine outcomes of admitted elderly trauma victims based on initial mechanism of injury and the degree to which other factors affected their overall outcome. A prospective study involving admitted patients > or =65 years was performed at an urban university center from September 15, 1996 until August 31, 1997. Patients sustaining any potentially serious form of trauma were included. Data about mechanism of injury (MOI), comorbid conditions, preinjury medications, types of injuries sustained, length of stay, functional outcome, and ultimate disposition were recorded. Two hundred thirty-nine consecutive patients were enrolled. Mean age was 78.1 +/- 8.1 years. There were 130 women (54%) and 109 men (46%). MOI was as follows: 132 low-mechanism falls (LMFs), 64 high-mechanism motor vehicle crashes (HMMVCs), 22 high-mechanism falls (HMFs), 8 pedestrian versus car (PVCs), and 13 other types. Mean length of stay surviving beyond the ED was 12.9 days. 8 patients were either DOA or died in the ED. There were 19 in-hospital deaths. Deaths were seen in 14% of HMMVCs, 13.6% HMFs, 9.1% LMFs, 25% PVCs, and 7.7% for other mechanisms. Overall outcomes by mechanism were categorized as functional (or baseline), fair, alive but poor, and dead. Functional outcomes were seen in 76.6% of HMMVCs, 81.8% of HMFs, 84.1% of LMFs, 50% of PVCs, and 84.6% for all other injuries. Forty-five percent were discharged home, 26% went to rehabilitation units, 16% went to nursing homes, and 11% died; the remaining 2% were either transferred to a psychiatric facility or to another hospital. Preexisting comorbid conditions did not appear to play a significant role in the ultimate outcomes of these patients. Severity of injury was the leading determinant of death, but severely injured patients often had functional outcomes. Elderly trauma victims most often achieve functional outcomes despite multiple or severe injuries.

Authors+Show Affiliations

Department of Emergency Medicine, Albany Medical College, NY 12208, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10999573

Citation

Ferrera, P C., et al. "Outcomes of Admitted Geriatric Trauma Victims." The American Journal of Emergency Medicine, vol. 18, no. 5, 2000, pp. 575-80.
Ferrera PC, Bartfield JM, D'Andrea CC. Outcomes of admitted geriatric trauma victims. Am J Emerg Med. 2000;18(5):575-80.
Ferrera, P. C., Bartfield, J. M., & D'Andrea, C. C. (2000). Outcomes of admitted geriatric trauma victims. The American Journal of Emergency Medicine, 18(5), 575-80.
Ferrera PC, Bartfield JM, D'Andrea CC. Outcomes of Admitted Geriatric Trauma Victims. Am J Emerg Med. 2000;18(5):575-80. PubMed PMID: 10999573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of admitted geriatric trauma victims. AU - Ferrera,P C, AU - Bartfield,J M, AU - D'Andrea,C C, PY - 2000/9/22/pubmed PY - 2000/10/7/medline PY - 2000/9/22/entrez SP - 575 EP - 80 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 18 IS - 5 N2 - Conflicting data exist as to the outcome of elderly victims of trauma. With recent improved outcomes for functional recovery, aggressive management of these patients has been advocated. The purpose of this study is to determine outcomes of admitted elderly trauma victims based on initial mechanism of injury and the degree to which other factors affected their overall outcome. A prospective study involving admitted patients > or =65 years was performed at an urban university center from September 15, 1996 until August 31, 1997. Patients sustaining any potentially serious form of trauma were included. Data about mechanism of injury (MOI), comorbid conditions, preinjury medications, types of injuries sustained, length of stay, functional outcome, and ultimate disposition were recorded. Two hundred thirty-nine consecutive patients were enrolled. Mean age was 78.1 +/- 8.1 years. There were 130 women (54%) and 109 men (46%). MOI was as follows: 132 low-mechanism falls (LMFs), 64 high-mechanism motor vehicle crashes (HMMVCs), 22 high-mechanism falls (HMFs), 8 pedestrian versus car (PVCs), and 13 other types. Mean length of stay surviving beyond the ED was 12.9 days. 8 patients were either DOA or died in the ED. There were 19 in-hospital deaths. Deaths were seen in 14% of HMMVCs, 13.6% HMFs, 9.1% LMFs, 25% PVCs, and 7.7% for other mechanisms. Overall outcomes by mechanism were categorized as functional (or baseline), fair, alive but poor, and dead. Functional outcomes were seen in 76.6% of HMMVCs, 81.8% of HMFs, 84.1% of LMFs, 50% of PVCs, and 84.6% for all other injuries. Forty-five percent were discharged home, 26% went to rehabilitation units, 16% went to nursing homes, and 11% died; the remaining 2% were either transferred to a psychiatric facility or to another hospital. Preexisting comorbid conditions did not appear to play a significant role in the ultimate outcomes of these patients. Severity of injury was the leading determinant of death, but severely injured patients often had functional outcomes. Elderly trauma victims most often achieve functional outcomes despite multiple or severe injuries. SN - 0735-6757 UR - https://www.unboundmedicine.com/medline/citation/10999573/Outcomes_of_admitted_geriatric_trauma_victims_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735675700940257 DB - PRIME DP - Unbound Medicine ER -