Parreira José Gustavo, Soldá Silvia C, Perlingeiro Jaqueline A Giannini, Padovese Camila C, Karakhanian Walter Z, Assef José Cesar
Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2010 Sep-Oct;56(5):541-6. doi: 10.1590/s0104-42302010000500014.
To assess the characteristics of traumas suffered by the elderly by comparison with a group of younger trauma victims.
Trauma protocols from June 10, 2008 to March 9, 2009 were evaluated including all trauma patients above 13 years of age admitted to the emergency room. Data were collected on trauma mechanism, preexisting diseases, vital signs on admission, injuries diagnosed, trauma index scores, tests and treatment. Patients over 60 years were assigned to the elderly group (Group I). Data were compared between this group and a group of younger patients (Group II), using Student's t test, the chi square test and Fisher's exact test, considering p<0.05 as significant.
Two thousand and seventy-five trauma victims were recruited (77.1% male), 211 (10.2%) in group I. The most frequent trauma mechanisms in the elderly were falls (from patients' own height) (41%) and being hit by automobiles (28%). Preexisting diseases were more frequent in Group I and included systemic arterial hypertension and diabetes mellitus. The most frequent injuries to Group I patients were to the extremities, affecting 106 patients (50.2%). Fractures were diagnosed in 18% of the elderly patients. In comparison with younger trauma patients, elderly patients had significantly higher head scores on the AIS (0.75 + 1.17 vs. 0.54 + 1.04) (p=0.014) and lower thoracic (0.15 + 0.62 vs. 0.26 + 0.86) (p=0.018) and abdominal scores (0.05 + 0.43 vs. 0.21 + 0.82) (p<0.001). Severe injuries (AIS > 3) to the head were more frequently observed in Group I (11.4% vs. 7%) (p=0,023). Certain types of injury were more frequent in Group I: subdural hematomas (2.8% vs. 0.8%) (p=0.008), subarachnoid hemorrhages (3.8% vs. 1.3%) (p=0.005) and cerebral contusions (5.2% vs. 2.3%) (p=0.015).
In comparison to younger trauma victims, the elderly group was characterized by a higher frequency of falls from their own height, concomitant diseases and severe intracranial injuries, including subdural hematoma, cerebral contusions and subarachnoid hemorrhages.
通过与一组年轻创伤受害者进行比较，评估老年人所遭受创伤的特点。
对2008年6月10日至2009年3月9日期间的创伤治疗记录进行评估，纳入所有13岁以上入住急诊室的创伤患者。收集有关创伤机制、既往疾病、入院时生命体征、诊断出的损伤、创伤指数评分、检查及治疗的数据。60岁以上患者被归入老年组（第一组）。使用学生t检验、卡方检验和Fisher精确检验对该组与一组年轻患者（第二组）的数据进行比较，将p<0.05视为具有显著性。
共招募了2075名创伤受害者（77.1%为男性），其中第一组有211名（10.2%）。老年人中最常见的创伤机制是（从自身高度）跌倒（41%）和被汽车撞击（28%）。第一组中既往疾病更为常见，包括系统性动脉高血压和糖尿病。第一组患者最常受伤的部位是四肢，有106名患者（50.2%）受影响。18%的老年患者被诊断为骨折。与年轻创伤患者相比，老年患者的简明损伤定级（AIS）头部评分显著更高（0.75 + 1.17 vs. 0.54 + 1.04）（p = 0.014），而胸部（0.15 + 0.62 vs. 0.26 + 0.86）（p = 0.018）和腹部评分（0.05 + 0.43 vs. 0.21 + 0.82）（p<0.001）更低。第一组中更常观察到头部的严重损伤（AIS>3）（11.4% vs. 7%）（p = 0.023）。某些类型的损伤在第一组中更为常见：硬膜下血肿（2.8% vs. 0.8%）（p = 0.008）、蛛网膜下腔出血（3.8% vs. 1.3%）（p = 0.005）和脑挫伤（5.2% vs. 2.3%）（p = 0.015）。
与年轻创伤受害者相比，老年组的特点是自身高度跌倒、合并疾病以及严重颅内损伤（包括硬膜下血肿、脑挫伤和蛛网膜下腔出血）的发生率更高。
