Baltazar Gerard A, Bassett Parker, Pate Amy J, Chendrasekhar Akella
Division of Trauma, Department of Surgery, St. Barnabas Hospital Health System, Bronx, NY, USA.
Division of Trauma, Department of Surgery, Richmond University Medical Center, Staten Island, NY, USA.
Pragmat Obs Res. 2017 Apr 26;8:43-47. doi: 10.2147/POR.S127710. eCollection 2017.
Motor vehicle collisions (MVCs) are a leading cause of injury in the US. While the probability of collision with a pedestrian (PMVC) has declined in recent years, the probability of a pedestrian fatality has risen. Our objective was to determine whether older age impacts potential outcomes in patients involved in low-velocity PMVCs.
We performed a retrospective-cohort study of adult patients aged >14 years involved in low-velocity pedestrian-MVCs (<15 miles per hour [24.14 km/h]), presenting to an urban level I trauma center from January to November 2013. Subjects were identified via trauma registry and stratified: ages 15-49 years and ≥50 years. Electronic medical records were reviewed for demographics, vital signs, and laboratory results on initial presentation, presence or absence of systemic inflammatory response syndrome (SIRS), shock index (SI), injury-severity score (ISS), length of stay (LOS), and survival to discharge. For statistical analysis, or Student's -tests were utilized.
Our study included 145 patients (77 female) with a mean age of 41.9±3 years; 95 patients were aged 15-49 years (mean 31.9±2.2 years), and 50 patients were aged ≥50 years or older (mean 62.44±2.9 years). Mean ISS was 10.05±1.95, mean SI was 0.68±0.03, and mean LOS was 3.67±0.57 days. A total of 41 patients met SIRS criteria on arrival, and nine patients expired (6.2%). Mean ISS (15.64±4.42 vs 7.1±1.64, <0.001) and mean SI (0.75±0.07 vs 0.65±0.03, =0.002) were higher in patients aged ≥50 years. Mean LOS was longer in older patients (5.22±1.14 vs 2.85±0.58 days, <0.001). Older age was associated with SIRS on arrival (=0.023) and associated with mortality (=0.004).
Age ≥50 years is associated with greater severity of injury and poor outcomes for patients involved in low-velocity PMVCs. Increased clinical attention and resource allocation should be directed toward older patients after low-velocity PMVCs.
机动车碰撞（MVC）是美国伤害的主要原因。虽然近年来与行人碰撞（PMVC）的概率有所下降，但行人死亡的概率却有所上升。我们的目的是确定年龄较大是否会影响低速PMVC患者的潜在结局。
我们对2013年1月至11月在城市一级创伤中心就诊的年龄>14岁的成年低速行人-MVC患者（速度<15英里/小时[24.14公里/小时]）进行了一项回顾性队列研究。通过创伤登记系统识别受试者并进行分层：15 - 49岁和≥50岁。回顾电子病历，记录初始就诊时的人口统计学、生命体征和实验室检查结果，是否存在全身炎症反应综合征（SIRS）、休克指数（SI）、损伤严重程度评分（ISS）、住院时间（LOS）以及出院存活率。统计分析采用t检验或学生t检验。
我们的研究纳入了145例患者（77例女性），平均年龄为41.9±3岁；95例患者年龄在15 - 49岁（平均31.9±2.2岁），50例患者年龄≥50岁（平均62.44±2.9岁）。平均ISS为10.05±1.95，平均SI为0.68±0.03，平均LOS为3.67±0.57天。共有41例患者到达时符合SIRS标准，9例患者死亡（6.2%）。≥50岁患者的平均ISS（15.64±4.42 vs 7.1±1.64，P<0.001）和平均SI（0.75±0.07 vs 0.65±0.03，P = 0.002）更高。老年患者的平均住院时间更长（5.22±1.14 vs 2.85±0.58天，P<0.001）。年龄较大与到达时的SIRS相关（P = 0.023）且与死亡率相关（P = 0.004）。
年龄≥50岁与低速PMVC患者的损伤严重程度增加和不良结局相关。低速PMVC后应给予老年患者更多的临床关注和资源分配。
