Singh Shridevi, DiGiacomo Jody C, Angus L D George, Cardozo-Stolberg Sara, Gerber Noam, Munnangi Swapna
Division of Trauma, Department of Surgery, Nassau University Medical Center, East Meadow, New York.
J Trauma Nurs. 2020 Mar/Apr;27(2):71-76. doi: 10.1097/JTN.0000000000000489.
A surgical post-acute treatment unit (SPA) was developed for acutely injured elderly patients who no longer warranted acute care in an intensive care setting to decrease complications by focusing increased bedside attention to cognition, nutrition, respiration, and mobilization. A retrospective review was performed comparing patients 65 years and older with isolated rib fractures treated before the SPA was opened with patients treated in the SPA. The 2 populations were comparable except the SPA group had a higher mean Injury Severity Score. Nine complications occurred in the pre-SPA group, and no complications occurred in the SPA patient population. Four patients in the pre-SPA group died compared with zero deaths for the SPA group. The rates of complications and mortality between elderly patients with isolated rib fractures were not statistically different between patients treated with a traditional admission to an inpatient ward and patients admitted to the SPA, even though the SPA patients had significantly more severe chest injuries. Establishing a physical environment to support the needs of elderly trauma patients with isolated rib fractures who no longer need the intensive care unit (ICU) is effective in decreasing the complications and unplanned returns to the ICU.
为不再需要在重症监护环境中接受急性护理的急性受伤老年患者开发了一个外科急性后期治疗单元（SPA），通过增加对认知、营养、呼吸和活动能力的床边关注来减少并发症。进行了一项回顾性研究，比较了65岁及以上孤立性肋骨骨折患者在SPA开放前接受治疗的情况与在SPA接受治疗的患者情况。除SPA组的平均损伤严重程度评分较高外，这两组人群具有可比性。SPA前组发生了9例并发症，而SPA患者人群未发生并发症。SPA前组有4例患者死亡，而SPA组为零死亡。尽管SPA患者的胸部损伤明显更严重，但在接受传统住院病房治疗的患者和入住SPA的患者之间，孤立性肋骨骨折老年患者的并发症和死亡率在统计学上没有差异。建立一个支持不再需要重症监护病房（ICU）的孤立性肋骨骨折老年创伤患者需求的物理环境，对于减少并发症和计划外返回ICU是有效的。
