Impact of geriatric trauma service on the outcome of older trauma patents
| Autor: | Emily Leede, Liam Fry, Stacey Hamilton, Sadia Ali, Louisa Crosby, Carlos V.R. Brown |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine Geriatric Nursing Trauma Centers Geriatric trauma 030502 gerontology law Intensive care medicine Humans Trauma team Nurse Practitioners Aged Retrospective Studies Aged 80 and over Geriatrics Service (business) Academic Medical Centers Rehabilitation business.industry Length of Stay medicine.disease Texas Intensive care unit Patient Discharge Intensive Care Units Emergency medicine Female 0305 other medical science business Trauma surgery 030217 neurology & neurosurgery |
| Zdroj: | Geriatrics & Gerontology International. 20:817-821 |
| ISSN: | 1447-0594 1444-1586 |
| Popis: | Aim The number of geriatric trauma patients is rising; yet, there is no established best team to care for them. This study analyzed a geriatric trauma service (GTS) that is integrated into the trauma surgery workflow rather than a separate consultation service. We hypothesize this team will lead to decreased mortality, shorter length of stay and increased favorable discharges for geriatric trauma patients. Methods In July 2017, we established a GTS consisting of geriatric nurse practitioners who were part of the hospital's geriatrics service, trauma surgeons and surgery residents on the acute care surgery service. The geriatric nurse practitioners were integrated into the trauma surgery workflow and functioned as independent members. The GTS responded to traumas and consultations for patients aged ≥65 years. Trauma surgeons carried out intensive care and operative management, while the geriatric nurse practitioners managed medical issues, family communication and end-of-life planning. We carried out a 2 year retrospective analysis of trauma patients aged ≥65 years seen at Dell Seton Medical Center at the University of Texas, Austin, Texas, USA, comparing patient outcomes before and after the GTS. The primary outcome was mortality, whereas secondary outcomes included hospital days, intensive care unit days, and discharge disposition. Results We found no difference in mortality, intensive care unit days or hospital days with the GTS. However, post-GTS patients were more often discharged to home, rehabilitation, or hospice, and less often to nursing homes. Conclusion An integrated geriatric and trauma team is feasible, and significant changes in disposition can be made by utilizing geriatric nurse practitioners. Geriatr Gerontol Int 2020; 20: 817-821. |
| Databáze: | OpenAIRE |
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