University of Maryland School of Medicine, Baltimore, MD.
Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, NH.
J Orthop Trauma. 2019 May;33(5):234-238. doi: 10.1097/BOT.0000000000001436.
To evaluate physical function and return to independence of geriatric trauma patients, to compare physical function outcomes of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors of physical function outcomes.
Retrospective.
Urban Level I trauma center.
Study group of 216 patients with high-energy trauma and comparison group of 117 patients with low-energy trauma.
Injury mechanism (high- vs. low-energy mechanism).
Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) patient-reported outcome measure, and change in living situation and mobility.
Physical function outcomes and return to independence differed between patients with high-energy and low-energy injuries. High-energy geriatric trauma patients had significantly higher PROMIS PF scores compared with low-energy geriatric trauma patients (PROMIS PF score 42.2 ± 10.4 vs. 24.6 ± 10.4, P < 0.001). High-energy geriatric trauma patients were able to ambulate outdoors without an assistive device in 67% of cases and were living independently 74% of the time in comparison with 28% and 45% of low-energy geriatric trauma patients, respectively (P < 0.001, P < 0.001). Multivariate linear regression analysis demonstrated that low-energy mechanism injury was independently associated with a 13.2 point reduction in PROMIS PF score (P < 0.001).
Geriatric patients greater than 1 year out from sustaining a high-energy traumatic injury seem to be functioning within the expected range for their age, whereas low-energy trauma patients seem to be functioning substantially worse than both age-adjusted norms and their high-energy cohorts.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估老年创伤患者的身体功能和恢复独立能力，比较高能量创伤和低能量创伤老年患者的身体功能结果，并确定身体功能结果的预测因素。
回顾性。
城市一级创伤中心。
研究组 216 例高能量创伤患者和对照组 117 例低能量创伤患者。
损伤机制（高能量与低能量机制）。
患者报告的结局测量信息系统身体功能（PROMIS PF）患者报告结局测量，以及生活状况和活动能力的变化。
高能量和低能量损伤老年患者的身体功能结果和恢复独立情况不同。与低能量老年创伤患者相比，高能量老年创伤患者的 PROMIS PF 评分显著更高（PROMIS PF 评分 42.2 ± 10.4 对 24.6 ± 10.4，P < 0.001）。高能量老年创伤患者中有 67%能够在户外不使用辅助设备行走，74%的时间能够独立生活，而低能量老年创伤患者分别为 28%和 45%（P < 0.001，P < 0.001）。多元线性回归分析表明，低能量机制损伤与 PROMIS PF 评分降低 13.2 分独立相关（P < 0.001）。
在遭受高能量创伤 1 年以上的老年患者中，身体功能似乎处于与其年龄相符的预期范围内，而低能量创伤患者的身体功能似乎明显低于年龄调整后的正常值和高能量创伤患者。
预后 III 级。请参阅作者说明，以获得完整的证据水平描述。
