Outcomes after Falls Continue to Worsen Despite Trauma and Geriatric Care Advancements
| Autor: | Jeffrey S. Young, Lily E. Johnston, Eric J. Charles, Trevor B. Parker, Carrie A Foster, Eleanor A. Sharp, Laura E. Barnes, Nicholas J. Napoli, Deirdre A Goode |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry Trauma center Glasgow Coma Scale 030208 emergency & critical care medicine Retrospective cohort study General Medicine medicine.disease Comorbidity Odds 03 medical and health sciences 0302 clinical medicine Intensive care Health care Emergency medicine medicine Injury Severity Score 030212 general & internal medicine business |
| Zdroj: | The American Surgeon. 84:392-397 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481808400323 |
| Popis: | The most common mechanism of traumatic injury is ground-level fall. The objective of this study was to understand how patients sustaining falls and their outcomes have evolved. An institutional trauma database was used to identify adult patients who suffered a fall and were admitted to a Level I trauma center during two distinct time periods: 1998 to 2003 (past) and 2008 to 2013 (current). Data on anticoagulant use and comorbidities was gathered by retrospective chart review of patients treated during 2003 and 2013. Univariable analyses and multivariable regression were used to evaluate demographics and outcomes. A total of 6116 patients were identified, with a 24 per cent increase in number of falls between groups. Current fall patients are older (70 vs 66 years, P < 0.001), more often admitted to intensive care (28 vs 12%, P < 0.001), have longer lengths of stay (5 vs 4 days, P < 0.001), are frequently discharged to skilled nursing facilities (24 vs 8%, P < 0.001), and have higher mortality (5 vs 3%, P = 0.002). The adjusted odds of mortality for patients treated during 2003 and 2013 was associated with age, gender, injury severity score, and Glasgow Coma Scale score. Current fall patients use more health care resources and have worse outcomes, despite advances in trauma and geriatric care. |
| Databáze: | OpenAIRE |
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