Division of Trauma, Department of Surgery, Stony Brook University Renaissance School of Medicine, Stony Brook, New York.
Division of Geriatric Medicine, Department of Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
J Surg Res. 2019 Sep;241:78-86. doi: 10.1016/j.jss.2019.03.031. Epub 2019 Apr 20.
Advanced age and comorbidities are recognized risk factors for adverse outcomes in elderly trauma patients. However, the contribution of the number and type of complications to in-hospital mortality in elderly blunt trauma admissions has not been extensively studied.
A retrospective review of the trauma registry at a level 1 trauma center for blunt trauma patients age ≥65 y hospitalized for at least 2 d between 2010 and 2015.
There were 2467 admissions, with a median age of 81 y and median injury severity score of 9. The most common mechanism of injury was a low-level fall. Approximately 19.6% of admissions had a complication: 11.1% major complications, 8.6% other complications. The in-hospital mortality rate was significantly different (P < 0.001) among the three groups at 16.1% of major complications group, 7.1% of other, and 2.1% of no complications (P < 0.001). On multivariate logistic regression, each major complication increased the odds for in-hospital mortality by 1.59-fold.
Complications are not infrequent in elderly blunt trauma admissions, despite a generally lower energy mechanism of injury. Each major complication is associated with increased odds of mortality. Multifaceted interventions for prevention and mitigation of complications are indicated.
高龄和合并症是老年创伤患者发生不良预后的公认危险因素。然而，并发症的数量和类型对老年钝性创伤患者住院期间死亡率的影响尚未得到广泛研究。
回顾性分析 2010 年至 2015 年期间在一家 1 级创伤中心住院至少 2 天的年龄≥65 岁的钝性创伤患者的创伤登记处。
共有 2467 例入院，中位年龄为 81 岁，损伤严重程度评分中位数为 9 分。最常见的损伤机制是低水平坠落。约 19.6%的患者发生并发症：11.1%为主要并发症，8.6%为其他并发症。三组患者的院内死亡率差异有统计学意义（P<0.001）：主要并发症组为 16.1%，其他并发症组为 7.1%，无并发症组为 2.1%（P<0.001）。多变量逻辑回归分析显示，每发生一种主要并发症，院内死亡率的比值比增加 1.59 倍。
尽管钝性创伤的致伤能量通常较低，但老年钝性创伤患者的并发症并不少见。每种主要并发症都与死亡率增加相关。需要采取多方面的干预措施来预防和减轻并发症。
