NYU Langone Orthopedic Hospital, NYU Langone Medical Center, New York, NY.
Jamaica Hospital Medical Center, Queens, NY.
J Orthop Trauma. 2018 Sep;32(9):461-466. doi: 10.1097/BOT.0000000000001242.
To determine whether a novel inpatient mortality risk assessment tool designed to be calculated in the emergency department setting can risk stratify patient-reported functional outcomes and mortality at 1 year.
Prospective cohort.
Academic level 1 trauma center.
Six hundred eight-five patients >55 years of age who were orthopaedic surgery consults or trauma surgery consults in the emergency department between January 10, 2014, and September 30, 2015.
Calculation of the validated score for trauma triage in the geriatric and middle-aged (STTGMA) using each patient's demographics, injury severity, and functional status.
Mortality, EQ-5D questionnaire, and percent return to baseline function since their hospitalization at 1-year after hospitalization.
Forty-five (6.6%) patients died within the year after hospitalization. Of remaining 639 patients available for follow-up, 247 (38.7%) were successfully contacted. There was no observed difference between patients who were successfully contacted and those who were not. The mean STTGMA score was 2.1% ± 3.6%. Patients reported on average a 76.4% ± 27.5% return to baseline function. When comparing patients between risk groups, there was a significant difference in EQ-5D scores and percent return to baseline. The Kaplan-Meier survival curve shows that high-risk patients had pronounced decreased survival within the initial days after discharge compared with other cohorts.
This study demonstrates that patients identified with the STTGMA tool as having an increased risk of inpatient mortality after trauma correlate with poorer functional outcomes at 1 year. The STTGMA risk score is also a valuable tool to stratify risk of mortality up to 1 year after discharge.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
确定一种新的住院患者死亡率风险评估工具，该工具旨在在急诊科环境下计算，是否能够对患者报告的功能结果和 1 年死亡率进行风险分层。
前瞻性队列研究。
学术水平 1 级创伤中心。
2014 年 1 月 10 日至 2015 年 9 月 30 日期间，在急诊科接受骨科手术或创伤外科手术会诊的 608 名年龄>55 岁的患者。
使用每位患者的人口统计学、损伤严重程度和功能状态计算经验证的创伤分诊中老年和中年评分（STTGMA）。
死亡率、EQ-5D 问卷以及患者自住院至住院后 1 年时功能恢复至基线的百分比。
45 名（6.6%）患者在住院后 1 年内死亡。在可进行随访的 639 名剩余患者中，有 247 名（38.7%）成功联系到。成功联系的患者与未联系的患者之间没有观察到差异。STTGMA 评分的平均值为 2.1%±3.6%。患者报告的平均功能恢复至基线的百分比为 76.4%±27.5%。当比较不同风险组的患者时，EQ-5D 评分和恢复至基线的百分比存在显著差异。Kaplan-Meier 生存曲线显示，高风险患者在出院后最初几天的生存率明显降低。
这项研究表明，在创伤后被 STTGMA 工具识别为住院死亡率增加的患者，其 1 年后的功能结果较差。STTGMA 风险评分也是在出院后 1 年内分层死亡率风险的有用工具。
预后 III 级。请参阅作者说明以获取完整的证据水平描述。
