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65 岁以上摩托车事故重伤者死亡率升高。

Increased Mortality Among Critically Injured Motorcyclists Over 65 Years of Age.

机构信息

Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius Maximilians University Würzburg; Department of Orthopedics and Trauma Surgery, Robert-Bosch-Krankenhaus Stuttgart; Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU).

出版信息

Dtsch Arztebl Int. 2019 Jul 8;116(27-28):479-485. doi: 10.3238/arztebl.2019.0479.

Abstract

BACKGROUND

Motorcycle accidents account for a large fraction of the patients with polytrauma treated in German hospitals. Clinical experience indicates that an in- creasing number of older motorcyclists are having accidents. We studied whether such individuals are subject to higher mortality and longer hospital stays.

METHODS

We retrospectively evaluated data from the Traumaregister DGU® (TR- DGU) concerning all patients (n = 13 850) who were registered in the TR-DGU as having sustained trauma in a motorcycle accident from 2002 to 2015 and who had an Injury Severity Score (ISS) greater than 8. The patients were divided into four age groups for further study.

RESULTS

Despite a nearly identical severity of anatomical injury according to the ISS, persons sustaining trauma in motorcycle accidents who were over 65 years of age (n = 892) needed longer and more intensive treatment than their younger counter- parts. They were invasively ventilated for a longer time (+ 1.2 days), kept for a longer time on the intensive care unit (+ 1.7 days), and stayed in the hospital three days longer. These older persons injured in motorcycle accidents had a disproportionate mortality in comparison to other polytrauma patients and a significantly elevated mor- tality in comparison to their younger counterparts-15.8%, compared to 7.2% among patients aged 45 to 64. Older trauma patients are more likely than younger ones to develop lethal complications in the later course of their hospitalization, while younger trauma patients who die generally do so as a direct result of the traumatic injury.

CONCLUSION

Patients over age 65 who sustain trauma in motorcycle accidents have a higher mortality, a longer duration of ventilation, and longer stays in the intensive care unit and in the hospital overall than their younger counterparts. These patients present a special challenge to the treating medical team.

摘要

背景

在德国医院接受多发伤治疗的患者中,摩托车事故占很大比例。临床经验表明,越来越多的老年摩托车骑手发生事故。我们研究了这些人是否会面临更高的死亡率和更长的住院时间。

方法

我们回顾性评估了 2002 年至 2015 年期间在德国创伤登记处(TR-DGU)登记的因摩托车事故受伤且损伤严重程度评分(ISS)大于 8 的所有患者(n = 13850)的数据。将患者分为四组进行进一步研究。

结果

尽管根据 ISS 评估的解剖损伤严重程度几乎相同,但年龄超过 65 岁(n = 892)的摩托车事故创伤患者需要比年轻患者更长、更密集的治疗。他们的机械通气时间延长了 1.2 天,在重症监护病房的停留时间延长了 1.7 天,住院时间延长了 3 天。与其他多发伤患者相比,这些年龄较大的摩托车事故受伤者的死亡率不成比例,与年轻患者相比,死亡率显著升高(15.8%比 45-64 岁患者的 7.2%)。老年创伤患者在住院后期比年轻患者更容易发生致命并发症,而死亡的年轻创伤患者通常是直接由创伤引起的。

结论

在摩托车事故中受伤且年龄超过 65 岁的患者的死亡率较高,通气时间、入住重症监护病房和住院时间均长于年轻患者。这些患者对治疗团队提出了特殊挑战。

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