Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
Am J Surg. 2018 Jul;216(1):42-45. doi: 10.1016/j.amjsurg.2017.09.011. Epub 2017 Sep 19.
BACKGROUND: Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered. METHODS: 446 older trauma patients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS). RESULTS: CCI and CPS were associated with HLOS in patients <65. In patients aged 45-65, only CPS was associated with HLOS. CPS was inversely associated with in-hospital mortality in patients <65, but not patients aged 45-65. CCI score was not associated with in-hospital mortality in either group. CONCLUSION: Increased CCI and CPS were associated with increased HLOS. In patients over 65, increased CPS was associated with decreased mortality. This could be due to return toward physiologic normalcy in treated patients not seen in their peers with undiagnosed or untreated comorbidities.
背景：预期寿命的延长导致创伤中心有更多的老年患者。仅评估损伤可能不够；应考虑年龄、合并症和药物。 方法：使用损伤严重程度评分（ISS）、Charlson 合并症指数（CCI）和合并症-多药治疗评分（CPS），对 446 名老年创伤患者进行了两组分析，年龄分别为 45-65 岁和<65 岁。 结果：CCI 和 CPS 与<65 岁患者的 HLOS 相关。在年龄在 45-65 岁的患者中，只有 CPS 与 HLOS 相关。CPS 与<65 岁患者的住院死亡率呈负相关，但与年龄在 45-65 岁的患者无关。CCI 评分与两组的住院死亡率均无关。 结论：CCI 和 CPS 的增加与 HLOS 的增加相关。在 65 岁以上的患者中，CPS 的增加与死亡率的降低相关。这可能是由于接受治疗的患者的生理状态恢复正常，而未被诊断或未经治疗的合并症患者则没有这种情况。
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