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老年创伤患者重症监护治疗的疗效

Efficacy of the Treatment of Elderly Trauma Patients Requiring Intensive Care.

作者信息

Oshima Kiyohiro, Murata Masato, Aoki Makoto, Nakajima Jun, Sawada Yusuke, Isshiki Yuta, Ichikawa Yumi, Fukushima Kazunori, Hagiwara Shuichi, Hinohara Hiroshi

机构信息

Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan.

Intensive Care Unit, Gunma University Hospital, Japan.

出版信息

Emerg Med Int. 2018 Dec 30;2018:2137658. doi: 10.1155/2018/2137658. eCollection 2018.

Abstract

PURPOSE

To evaluate the effectiveness of intensive care for the elderly trauma patients aged 80 years and older.

METHODS

Trauma patients admitted to the intensive care unit (ICU) through the emergency room (ER) at our hospital between January 2013 and December 2016 were analyzed. Patients were divided into two groups: patients aged 80 and older (group E) and <80 years old (group Y). Clinical courses and the total treatment costs were compared between the two groups. Data are shown as median (interquartile range).

RESULTS

A hundred and seven trauma patients were included in the study. There were 26 patients in group E and 81 patients in group Y. There was no significant difference in Injury Severity Score (ISS) (group E, 19 (13, 32); group Y, 17 (14, 25); p=0.708); however, the probability of survival (Ps) was significantly lower in group E (group E, 0.895 (0.757, 0.950); group Y, 0.955 (0.878, 0.986); p=0.004). The duration of ICU stay (days) was significantly longer in group E (10 (5, 23)) than in group Y (4 (3, 9); p=0.001), and the total hospital stay (days) was longer in group E (33 (13, 57)) than in group Y (22 (12, 42); p=0.179). The hospital mortality was higher in group E (11.5%) than in group Y (6.2%) without a significant difference (p=0.365). The total treatment costs were significantly higher in group E ($23,558 (12,456, 42,790) with $1 = ¥110.57) than in group Y ($16,538 (7,412, 25,422); p=0.023).

CONCLUSIONS

Elderly trauma patients require longer-term treatment including ICU stay and greater cost with higher hospital mortality compared with young trauma patients.

摘要

目的

评估对80岁及以上老年创伤患者进行重症监护的有效性。

方法

对2013年1月至2016年12月期间通过我院急诊室(ER)收治入重症监护病房(ICU)的创伤患者进行分析。患者分为两组:80岁及以上患者(E组)和80岁以下患者(Y组)。比较两组的临床病程和总治疗费用。数据以中位数(四分位间距)表示。

结果

107例创伤患者纳入研究。E组26例,Y组81例。损伤严重程度评分(ISS)无显著差异(E组,19(13,32);Y组,17(14,25);p = 0.708);然而,E组的生存概率(Ps)显著较低(E组,0.895(0.757,0.950);Y组,0.955(0.878,0.986);p = 0.004)。E组的ICU住院时间(天)显著长于Y组(10(5,23))(Y组为4(3,9);p = 0.001),E组的总住院时间(天)长于Y组(33(13,57))(Y组为22(12,42);p = 0.179)。E组的医院死亡率高于Y组(11.5%),但无显著差异(p = 0.365)。E组的总治疗费用显著高于Y组(23,558美元(12,456,42,790),1美元 = 110.57元人民币)(Y组为16,538美元(7,412,25,422);p = 0.023)。

结论

与年轻创伤患者相比,老年创伤患者需要包括ICU住院在内的更长时间治疗,费用更高,医院死亡率也更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e2e/6332988/d8b94469e9d3/EMI2018-2137658.001.jpg

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