Dugan James P, Burns Keith M, Baldawi Mustafa, Heidt David G
University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
University of Toledo Medical Center, Department of Surgery, Toledo, OH, USA.
Am J Surg. 2017 Dec;214(6):1048-1052. doi: 10.1016/j.amjsurg.2017.09.001. Epub 2017 Sep 19.
The elderly account for a large proportion of morbidity and mortality secondary to trauma, despite lower-energy mechanisms of injury and fewer trauma admissions. The benefit of geriatric trauma consultation services (GTCS) to this population remains unclear.
We performed a retrospective cohort analysis of a GTCS, which was established in January 2015. Patients over 60 admitted to the trauma service from January of 2014 to February 2016 were eligible.
There were no significant differences in 30-day and in-hospital mortalities, mean ICU and total lengths of stay, or complication rates. However, if a single complication was experienced, post-GTCS patients were nearly three times more likely to experience multiple complications. More patients in the GTCS group were discharged home, but were readmitted four times more often.
A mandatory GTCS was not associated with improved patient outcomes, suggesting that management exclusively by the trauma team is at least equally effective in treatment of geriatric trauma.
尽管老年人创伤的致伤机制能量较低且创伤入院人数较少，但他们在创伤继发的发病率和死亡率中占很大比例。老年创伤会诊服务（GTCS）对这一人群的益处仍不明确。
我们对2015年1月设立的GTCS进行了回顾性队列分析。纳入2014年1月至2016年2月入住创伤科的60岁以上患者。
30天死亡率、住院死亡率、平均重症监护病房（ICU）住院时间、总住院时间或并发症发生率均无显著差异。然而，如果患者发生单一并发症，GTCS会诊后的患者发生多种并发症的可能性几乎是前者的三倍。GTCS组更多患者出院回家，但再次入院的频率高出四倍。
强制性的GTCS与改善患者预后无关，这表明仅由创伤团队进行管理在老年创伤治疗中至少同样有效。
