Severely Injured Geriatric Patients Return to Independent Living
| Autor: | J. A. van Aalst, Richard S. Miller, H. K. Yates, Sue M. Bass, John A. Morris |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
medicine.medical_specialty
Rehabilitation business.industry medicine.medical_treatment Head injury Poison control Critical Care and Intensive Care Medicine medicine.disease Surgery Geriatric trauma Blunt trauma Internal medicine Injury prevention medicine Injury Severity Score Functional ability business |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 31:1096-1102 |
| ISSN: | 0022-5282 |
| DOI: | 10.1097/00005373-199131080-00008 |
| Popis: | Our previous work demonstrated that geriatric trauma patients (age greater than 65 years) consume disproportionate amounts of health care resources. In the past we hypothesized that late mortality is high, long-term outcome is poor, and return to independence is low in a severely injured geriatric population. Of 6,480 trauma admissions over 5 years, geriatric patients (n = 495) with blunt trauma injury (n = 421) and an ISS greater than 16 (n = 105) who survived until discharge (n = 61) underwent long-term follow-up (mean = 2.82 years). We surveyed 20 measures of functional ability; 10 measures of independence; availability and use of rehabilitation resources; employment history; alcohol use; support systems; and nursing home requirements. Of the 105 patients, 7 were subsequently lost to follow-up. Among the remaining 98, 44 (44.9%) died in hospital and 54 (55.1%) were discharged and interviewed. The mean age of the contacted patients was 72.6; their mean ISS was 23.3. Forty eight of 54 (88.9%) were alive at the time of interview, while 6/54 (11.1%) had died. Although only 8/48 patients regained their preinjury level of function, 32/48 (67%) returned to independent living. The 32 independent patients, those with "acceptable" outcome, were compared with an "unacceptable" outcome group composed of the 44 in-hospital deaths, the 6 late deaths, and the 16 dependent patients. Factors associated with poor outcome include a GCS score less than or equal to (p = 0.001), age greater than or equal to 75 (p = 0.004), shock upon admission (p = 0.014), presence of head injury (p = 0.03), and sepsis (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|