Ozmen Ozgur, Aksoy Mehmet, Ince Ilker, Dostbil Aysenur, Dogan Nazim, Kursad Husnu
Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.
Eurasian J Med. 2020 Feb;52(1):1-5. doi: 10.5152/eurasianjmed.2019.19194.
This retrospective study aimed to compare the clinical characteristics and trauma scores of Intensive Care Unit (ICU) trauma patients 65 years and older with the patients under 65 years old.
Trauma patients (n=161) who stayed at least 24 hours in ICU were included. Patients younger than 65 years were included into Group 1 (n=109) and patients aged ≥65 years (n=52) were included into Group 2. Patient characteristics and trauma index scores (GCS; APACHE II score, ISS; TRISS and RTS) at ICU admission were calculated.
The patients in Group 2 had more comorbid disease compared with Group 1 (61.5%, 6.4%) (p=0.001). The Trauma-related Injury Severity Score score were higher in Group 1 (49.76±33.75) compared with Group 2 (35.38±34.93) (p=0.006). The APACHE II score were higher in Group 2 (20.08±7.60) compared with Group 1 (17.00±6.90) (p=0.007). The need for invasive mechanical ventilation and tracheostomy were more frequent in Group 2 trauma patients compared with those of patients in Group 1 (92.3%, 73.4%; p=0.003; 26.9%, 8.3%; p=0.002; respectively). The need for transfusion of packed red blood cell suspension (PRBC) was more frequent in Group 2 compared with Group 1 (92.3%, 55.0%; respectively) (p=0.001). The mortality rate was found to be higher in Group 2 compared with Group 1 (48.1%, 19.3%; respectively) (p=0.001).
The elderly trauma patients have more comorbid disease, higher scores for APACHE II and lower scores for TRISS, more mechanical ventilation and tracheostomy requirements and higher mortality rate compared with young trauma patients.
本回顾性研究旨在比较65岁及以上重症监护病房(ICU)创伤患者与65岁以下患者的临床特征和创伤评分。
纳入在ICU至少停留24小时的创伤患者(n = 161)。65岁以下患者纳入第1组(n = 109),65岁及以上患者(n = 52)纳入第2组。计算ICU入院时的患者特征和创伤指数评分(GCS;急性生理与慢性健康状况评分系统II [APACHE II]评分、损伤严重度评分[ISS];创伤和损伤严重度评分[TRISS]及修订创伤评分[RTS])。
与第1组相比,第2组患者的合并症更多(61.5%对6.4%)(p = 0.001)。第1组的创伤相关损伤严重度评分高于第2组(49.76±33.75对35.38±34.93)(p = 0.006)。第2组的APACHE II评分高于第1组(20.08±7.60对17.00±6.90)(p = 0.007)。与第1组患者相比,第2组创伤患者有创机械通气和气管切开的需求更频繁(分别为92.3%对73.4%;p = 0.003;26.9%对8.3%;p = 0.002)。与第1组相比,第2组输注浓缩红细胞悬液(PRBC)更加频繁(分别为92.3%对55.0%)(p = 0.001)。发现第2组的死亡率高于第1组(分别为48.1%对19.3%)(p = 0.001)。
与年轻创伤患者相比,老年创伤患者合并症更多,APACHE II评分更高,TRISS评分更低,机械通气和气管切开需求更多,死亡率更高。