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老年病会诊可减少老年创伤患者出院时的高风险药物使用。

Geriatric Consultation Reduces High-risk Medication Usage at Discharge in Elderly Trauma Patients.

作者信息

Sharma Jyoti, Parulekar Manisha, Stewart Peter, Blatt Melissa, Zielonka Tania, Nyirenda Themba, Rogers Christopher, Tank Lisa

机构信息

Surgery, Hackensack University Medical Center, Hackensack, USA.

Internal Medicine, Hackensack Univeristy Medical Center, Hackensack, USA.

出版信息

Cureus. 2018 Nov 28;10(11):e3649. doi: 10.7759/cureus.3649.

Abstract

Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage. Methods Patients eligible for a GC, age ≥ 65, and length of stay > two days, were identified via a chart review from July 2013 to July 2014 at a Level II trauma center. This population was divided into those with and without a GC. Data collected included demographics, injury severity, medications, delirium, mortality, and readmissions. High-risk medications were defined using the Beers Criteria. Statistical analysis involved using appropriate standard tests to compare groups, including multivariate logistic regression. Results Forty-nine of a total of 104 patients received a GC. Groups were comparable on injury severity score, co-morbidities, and high-risk medication use upon admissions. The GC group was 74% less likely to be discharged on high-risk medications than the non-GC group. Conclusion GC in elderly trauma patients reduces high-risk medication use upon discharge. Further studies are needed to explore how GC impacts readmission rates and mortality. A multidisciplinary trauma team, including a geriatrician, must exist to address the unique medical, psychological, functional, and social issues of a growing, aged trauma population.

摘要

背景

在日益增长的老年人群中,创伤性损伤与更高的死亡率和并发症发生率相关。老年病会诊(GC)对于降低导致不良后果的风险因素至关重要。本研究旨在确定接受老年病会诊是否会对高风险药物的使用产生影响。方法:通过对2013年7月至2014年7月在一家二级创伤中心的病历审查,确定年龄≥65岁且住院时间>2天、符合老年病会诊条件的患者。该人群被分为接受和未接受老年病会诊的两组。收集的数据包括人口统计学、损伤严重程度、药物、谵妄、死亡率和再入院情况。高风险药物使用依据《Beers标准》进行定义。统计分析采用适当的标准检验来比较各组,包括多因素逻辑回归分析。结果:104例患者中共有49例接受了老年病会诊。两组在入院时的损伤严重程度评分、合并症和高风险药物使用方面具有可比性。与未接受老年病会诊的组相比,接受老年病会诊的组出院时使用高风险药物的可能性降低了74%。结论:老年创伤患者接受老年病会诊可降低出院时高风险药物的使用。需要进一步研究以探讨老年病会诊如何影响再入院率和死亡率。必须组建一个包括老年病医生在内的多学科创伤团队,以解决日益增多的老年创伤人群独特的医疗、心理、功能和社会问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/942b/6351116/3eb29630cf16/cureus-0010-00000003649-i01.jpg

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