Gironda Melanie W, Nguyen Annie L, Mosqueda Laura M
Department of Family Medicine, Keck School of Medicine, University of Southern California, Alhambra, California.
J Am Geriatr Soc. 2016 Aug;64(8):1651-5. doi: 10.1111/jgs.14246. Epub 2016 Jul 15.
To examine the relationship between individual characteristics and potential correlates of elder abuse in older adults who present with fractures.
Cross-sectional analysis of deidentified data extracted from medical records.
Academic medical center.
Individuals aged 65 and with a primary diagnosis of any fracture admitted to an outpatient department or emergency department (ED) in a single southern California medical center over a 36-month period (N = 652).
Participant characteristics included demographic characteristics, number of medical visits, and point of service. Corresponding International Classification of Diseases, Ninth Revision (ICD-9) codes, E-codes, and V-codes were extracted to identify cause, location, and type of fracture. The presence of 13 potential correlates of abuse as captured by ICD-9 codes were extracted and summed. Descriptive statistics and regression models were used for analyses.
Mean age of participants was 77.2, 58% were female (58%), 60% were white (60%), and 46% had one or more potential correlates of abuse. In bivariate analyses, older age (≥80), dementia, seeking care in the ED (vs inpatient or outpatient clinics), only one visit to a medical facility (vs multiple visits) in the 36-month study period, cause of fracture as something other than a fall, and fractures of the head or face were more likely to have at least one correlate of abuse. In logistic regression, dementia (B = 0.794, standard error (SE) = 0.280); seeking care in the ED (vs outpatient or outpatient clinics) (B = 1.86, SE = 0.302); at least two visits to a medical facility (vs multiple visits) (B = -0.585, SE = 0.343); and fracture of the back (B = 0.730, SE = 0.289), head (B = 1.22, SE = 0.333), and face (B = 1.28, SE = 0.474) were associated with the presence of at least one correlate of abuse.
Certain characteristics in older adults with fracture are associated with potential correlates of abuse. Medical practitioners should have a heightened awareness when these signs are present.
探讨骨折老年患者的个体特征与虐待老年人潜在相关因素之间的关系。
对从医疗记录中提取的去识别化数据进行横断面分析。
学术医疗中心。
在加利福尼亚州南部一家医疗中心的36个月期间，年龄在65岁及以上且主要诊断为任何骨折并入住门诊部或急诊科（ED）的患者（N = 652）。
参与者特征包括人口统计学特征、就诊次数和服务点。提取相应的国际疾病分类第九版（ICD - 9）编码、E编码和V编码，以确定骨折的原因、部位和类型。提取并汇总由ICD - 9编码捕获的13种潜在虐待相关因素的存在情况。采用描述性统计和回归模型进行分析。
参与者的平均年龄为77.2岁，58%为女性，60%为白人，46%有一个或多个潜在虐待相关因素。在双变量分析中，年龄较大（≥80岁）、患有痴呆症、在急诊科就诊（与住院或门诊诊所相比）、在36个月的研究期间仅到医疗机构就诊一次（与多次就诊相比）、骨折原因不是跌倒以及头部或面部骨折的患者更有可能至少有一个虐待相关因素。在逻辑回归中，痴呆症（B = 0.794，标准误（SE）= 0.280）；在急诊科就诊（与门诊或门诊诊所相比）（B = 1.86，SE = 0.302）；至少两次到医疗机构就诊（与多次就诊相比）（B = -0.585，SE = 0.343）；以及背部骨折（B = 0.730，SE = 0.289）、头部骨折（B = 1.22，SE = 0.333）和面部骨折（B = 1.28，SE = 0.474）与至少有一个虐待相关因素有关。
骨折老年患者的某些特征与虐待潜在相关因素有关。当出现这些迹象时，医生应提高警惕。
