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老年患者的创伤:患病率、合并症及性别差异研究

Trauma in elderly patients: a study of prevalence, comorbidities and gender differences.

作者信息

Gioffrè-Florio M, Murabito L M, Visalli C, Pergolizzi F P, Famà F

出版信息

G Chir. 2018 Jan-Feb;39(1):35-40. doi: 10.11138/gchir/2018.39.1.035.

Abstract

AIM

Trauma, in geriatric patients, increases with age, and is a leading cause of disability and institutionalization, resulting in morbidity and mortality. The aim of our study was to analyse the prevalence of trauma, the related risk factors, mortality and sex differences in the prevalence in a geriatric population.

PATIENTS AND METHOD

We observed 4,554 patients (≥65 years) with home injuries or car accidents. Patients were evaluated with ISS (Injury Severity Score) and major trauma with ATLS (Advanced Trauma Life Support). The instrumental investigation was in the first instance, targeted X-Ray or whole-body CT.

RESULTS

In over four years of study we treated 4,554 geriatric: 2,809 females and 1,745 Males. When the type of trauma was analysed the most common was head injury, followed by fractures of lower and upper limbs. In our experience hospitalization mainly involved patients over 80. In all patients mortality during assessment was 0.06%.

DISCUSSION

The geriatric patient is often defined as a "frail elderly", for the presence of a greater "injury sensitivity". This is due to the simultaneous presence of comorbidity, progressive loss of full autonomy and exposure to a high risk of traumatic events. Optimal management of the trauma patient can considerable reduce mortality and morbidity.

CONCLUSIONS

Falls and injuries in geriatric age are more frequent in women than in men. Among typical elder comorbidities, osteoporosis certainly causes a female preponderance in the prevalence of fractures. Our discharge data demonstrate that disability, which requires transfer to health care institutions, has a greater effect on women than men.

摘要

目的

老年患者的创伤发生率随年龄增长而增加,是导致残疾和入住养老机构的主要原因,会引发发病和死亡。我们研究的目的是分析老年人群中创伤的患病率、相关危险因素、死亡率以及患病率的性别差异。

患者与方法

我们观察了4554例(≥65岁)在家受伤或遭遇车祸的患者。采用损伤严重度评分(ISS)对患者进行评估,并用高级创伤生命支持(ATLS)评估严重创伤情况。首先进行的影像学检查是针对性的X线检查或全身CT检查。

结果

在超过四年的研究中,我们治疗了4554例老年患者:2809例女性和1745例男性。分析创伤类型时,最常见的是头部损伤,其次是下肢和上肢骨折。根据我们的经验,住院治疗的主要是80岁以上的患者。所有患者在评估期间的死亡率为0.06%。

讨论

老年患者常被定义为“体弱老人”,因为他们具有更高的“损伤敏感性”。这是由于同时存在合并症、逐渐丧失完全自主能力以及面临高创伤事件风险。对创伤患者进行优化管理可显著降低死亡率和发病率。

结论

老年女性跌倒和受伤的情况比男性更频繁。在典型的老年合并症中,骨质疏松症肯定导致女性在骨折患病率上占优势。我们的出院数据表明,需要转至医疗机构的残疾情况对女性的影响大于男性。

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