Division of General Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA.
J Surg Res. 2013 Sep;184(1):582-5. doi: 10.1016/j.jss.2013.03.021. Epub 2013 Mar 28.
As the population ages, trauma in the elderly is an increasingly recognized source of elderly morbidity. However, previous reviews on the topic provide only broad recommendations. The purpose of this study was to examine the elderly recidivist cohort at an urban trauma center for mechanisms of repeat injury.
The trauma registry at a major urban trauma center was queried to identify all patients aged 65 and older admitted from 1991-2010. Recidivist admissions were compared to nonrecidivist admissions. Demographics, mechanism of injury, injury location, length of stay, and mortality data were collected. Recidivists' mechanism of injury was compared with their initial mechanism of injury. Descriptive statistics, Student t-test, and a z-rank test of proportions were applied with significance set to P ≤ 0.05.
Between 1991 and 2010, 6476 patients aged 65+ were admitted, of which 79 (1.22%) were recidivists. Of these, 64 patients were aged 65 and older for both admissions. Most often, recidivists were male (70% versus 60%) and injured in penetrating trauma (17% versus 7.5%, P = 0.045). Recidivists trended towards more frequent injuries in bicycle collisions (3% versus 1.9%) and all-terrain vehicle (ATV)/motorcycle crashes (6.3% versus 1.7%), but were less likely to be hit by cars (49% versus 36%, P = 0.034). At least two thirds of recidivist patients injured in falls, ATV/motorcycle accidents, and stabbings had previously been injured by the same mechanism.
The overall recidivism rate in the elderly population is low. Nevertheless, recidivists were more susceptible to penetrating trauma, ATV/motorcycle collisions, and possibly bicycle accidents. These findings can help design counseling initiatives and injury prevention programs that target specific elderly trauma patients.
随着人口老龄化，老年人创伤成为老年人发病的一个越来越被认识到的原因。然而，之前关于这个主题的综述只提供了广泛的建议。本研究的目的是研究城市创伤中心的老年再入院患者，以了解重复受伤的机制。
对一家主要城市创伤中心的创伤登记处进行了查询，以确定 1991-2010 年期间所有 65 岁及以上的入院患者。将再入院患者与非再入院患者进行比较。收集人口统计学、损伤机制、损伤部位、住院时间和死亡率数据。将再入院患者的损伤机制与其初次损伤机制进行比较。应用描述性统计、学生 t 检验和比例 z 检验，显著性水平设为 P≤0.05。
1991 年至 2010 年间，共有 6476 名 65 岁及以上的患者入院，其中 79 名（1.22%）为再入院患者。其中，64 名患者两次入院时均为 65 岁及以上。再入院患者中，男性（70%对 60%）和穿透性损伤（17%对 7.5%）更为常见（P=0.045）。再入院患者更倾向于自行车碰撞（3%对 1.9%）和全地形车/摩托车事故（6.3%对 1.7%），但不太可能被汽车撞伤（49%对 36%）（P=0.034）。至少三分之二的因跌倒、全地形车/摩托车事故和刺伤而再入院的患者，之前曾因同一机制受伤。
老年人群的总体再入院率较低。然而，再入院患者更容易受到穿透性创伤、全地形车/摩托车事故和可能的自行车事故的影响。这些发现有助于制定针对特定老年创伤患者的咨询计划和伤害预防计划。
