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Geriatric outcomes are improved by a geriatric trauma consultation service.
J Trauma. 2006 Nov; 61(5):1040-6.JT

Abstract

BACKGROUND

Traumatic injuries in older patients are complex and have significant impact on the individual, their family, and trauma centers. We hypothesized that greater attention to the timely identification and comprehensive management of comorbid conditions would improve outcomes in the care of the older injured patient.

METHODS

This was a prospective, descriptive study of all patients 65 years of age and older admitted to the trauma service. Each elder was seen by a specialist in geriatrics ideally within 24 hours of admission to the trauma service. A standardized consult was developed for the electronic medical record and utilized in every case. Data were obtained from the trauma registry to characterize the nature of injury, injury severity, and outcome. Data from the geriatric consult were compiled to determine the impact of age- associated conditions on the outcome.

RESULTS

There were 285 injured patients, aged 65 years and older. Of these, 114 were seen in consultation. Age range was 65 to 96 years, with an average of 77.7 years. Injury Severity Score range was 3 to 75, with an average of 9.3. There were an equal number of male and female patients. Falls and motor vehicle collisions predominated. Geriatricians identified the following: 14% of patients presented with alcohol issues; 36% of patients exhibited signs of delirium; and 46% of patients presented with new medical conditions. Geriatricians assisted with advanced care planning in 15% of cases; disposition decisions to promote function in 49%; made medication changes in 65%; decreased inappropriate medications in 20%; and assisted with pain management in 42%. Trauma surgeons followed one or more recommendations in 91%.

CONCLUSION

Outcomes of older patients can be improved through geriatricians' expertise by addressing new and existing medical issues and reducing hospital-acquired complications such as functional decline, falls, delirium, and death.

Authors+Show Affiliations

Department of Surgery, Summa Health System, Akron City Hospital, Akron, Ohio 44309, USA. fallonw@summa-health.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17099506

Citation

Fallon, William F., et al. "Geriatric Outcomes Are Improved By a Geriatric Trauma Consultation Service." The Journal of Trauma, vol. 61, no. 5, 2006, pp. 1040-6.
Fallon WF, Rader E, Zyzanski S, et al. Geriatric outcomes are improved by a geriatric trauma consultation service. J Trauma. 2006;61(5):1040-6.
Fallon, W. F., Rader, E., Zyzanski, S., Mancuso, C., Martin, B., Breedlove, L., DeGolia, P., Allen, K., & Campbell, J. (2006). Geriatric outcomes are improved by a geriatric trauma consultation service. The Journal of Trauma, 61(5), 1040-6.
Fallon WF, et al. Geriatric Outcomes Are Improved By a Geriatric Trauma Consultation Service. J Trauma. 2006;61(5):1040-6. PubMed PMID: 17099506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geriatric outcomes are improved by a geriatric trauma consultation service. AU - Fallon,William F,Jr AU - Rader,Erin, AU - Zyzanski,Stephen, AU - Mancuso,Charlene, AU - Martin,Berni, AU - Breedlove,Linda, AU - DeGolia,Peter, AU - Allen,Kyle, AU - Campbell,James, PY - 2006/11/14/pubmed PY - 2006/12/23/medline PY - 2006/11/14/entrez SP - 1040 EP - 6 JF - The Journal of trauma JO - J Trauma VL - 61 IS - 5 N2 - BACKGROUND: Traumatic injuries in older patients are complex and have significant impact on the individual, their family, and trauma centers. We hypothesized that greater attention to the timely identification and comprehensive management of comorbid conditions would improve outcomes in the care of the older injured patient. METHODS: This was a prospective, descriptive study of all patients 65 years of age and older admitted to the trauma service. Each elder was seen by a specialist in geriatrics ideally within 24 hours of admission to the trauma service. A standardized consult was developed for the electronic medical record and utilized in every case. Data were obtained from the trauma registry to characterize the nature of injury, injury severity, and outcome. Data from the geriatric consult were compiled to determine the impact of age- associated conditions on the outcome. RESULTS: There were 285 injured patients, aged 65 years and older. Of these, 114 were seen in consultation. Age range was 65 to 96 years, with an average of 77.7 years. Injury Severity Score range was 3 to 75, with an average of 9.3. There were an equal number of male and female patients. Falls and motor vehicle collisions predominated. Geriatricians identified the following: 14% of patients presented with alcohol issues; 36% of patients exhibited signs of delirium; and 46% of patients presented with new medical conditions. Geriatricians assisted with advanced care planning in 15% of cases; disposition decisions to promote function in 49%; made medication changes in 65%; decreased inappropriate medications in 20%; and assisted with pain management in 42%. Trauma surgeons followed one or more recommendations in 91%. CONCLUSION: Outcomes of older patients can be improved through geriatricians' expertise by addressing new and existing medical issues and reducing hospital-acquired complications such as functional decline, falls, delirium, and death. SN - 0022-5282 UR - https://www.unboundmedicine.com/medline/citation/17099506/Geriatric_outcomes_are_improved_by_a_geriatric_trauma_consultation_service_ L2 - http://dx.doi.org/10.1097/01.ta.0000238652.48008.59 DB - PRIME DP - Unbound Medicine ER -