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老年雪地摩托创伤:类似损伤后的更长疗程。

Geriatric Snowmobile Trauma: Longer Courses After Similar Injuries.

机构信息

Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, New Hampshire.

Biomedical Data Science Department, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire.

出版信息

J Surg Res. 2021 Jun;262:85-92. doi: 10.1016/j.jss.2020.12.060. Epub 2021 Feb 4.

Abstract

BACKGROUND

Snowmobiling is a popular activity that leads to geriatric trauma admissions; however, this unique trauma population is not well characterized. We aimed to compare the injury burden and outcomes for geriatric versus nongeriatric adults injured riding snowmobiles.

MATERIALS AND METHODS

A retrospective cohort study was performed using the National Trauma Databank comparing nongeriatric (18-64) and geriatric adults (≥65) presenting after snowmobile-related trauma at level 1 and 2 trauma centers from 2011 to 2015. Demographic, admission, injury, and outcome data were collected and compared. A multivariate logistic regression model assessed for risk factors associated with severe injury (Injury Severity Score >15). Analysis was also performed using chi square, analysis of variance, and Kruskal-Wallis testing.

RESULTS

A total of 2471 adult patients with snowmobile trauma were identified; 122 (4.9%) were geriatric. Rates of severe injury (Injury Severity Score >15) were similar between groups, 27.5% in geriatric patients and 22.5% in nongeriatric adults (P = 0.2). Geriatric patients experienced higher rates of lower extremity injury (50.4 versus 40.3%, P = 0.03), neck injury (4.1 versus 1.4%, P = 0.02), and severe spine injury (20.6 versus 7.0%, P = 0.004). Geriatric patients had longer hospitalizations (5 versus 3 d, P < 0.0001), rates of discharge to a facility (36.8% versus 12%, P < 0.0001), and higher mortality (4.1 versus 0.6%, P < 0.0001). Geriatric age did not independently increase the risk for severe injury.

CONCLUSIONS

Geriatric age was not a significant predictor of severe injury after snowmobile trauma; however, geriatric patients suffered unique injuries, had longer hospitalizations, had higher rates of discharge to a facility, and had higher mortality. Tailored geriatric care may improve outcomes in this unique sport-related trauma population.

摘要

背景

雪地摩托是一种很受欢迎的活动,会导致老年创伤患者入院;然而,这种独特的创伤人群并没有得到很好的描述。我们旨在比较骑雪地摩托受伤的老年和非老年成年人的受伤负担和结果。

材料和方法

使用国家创伤数据库进行回顾性队列研究,比较了 2011 年至 2015 年在 1 级和 2 级创伤中心因雪地摩托相关创伤而就诊的非老年(18-64 岁)和老年(≥65 岁)成年人。收集并比较了人口统计学、入院、损伤和结果数据。多变量逻辑回归模型评估了与严重损伤(损伤严重程度评分>15)相关的风险因素。还使用卡方检验、方差分析和克鲁斯卡尔-沃利斯检验进行了分析。

结果

共确定了 2471 名雪地摩托创伤成年患者;122 名(4.9%)为老年患者。两组严重损伤(损伤严重程度评分>15)的发生率相似,老年患者为 27.5%,非老年成年人为 22.5%(P=0.2)。老年患者下肢损伤发生率较高(50.4%比 40.3%,P=0.03)、颈部损伤发生率较高(4.1%比 1.4%,P=0.02)和严重脊柱损伤发生率较高(20.6%比 7.0%,P=0.004)。老年患者的住院时间较长(5 天比 3 天,P<0.0001)、出院到医疗机构的比例较高(36.8%比 12%,P<0.0001)和死亡率较高(4.1%比 0.6%,P<0.0001)。老年年龄并不是雪地摩托创伤后严重损伤的独立预测因素。然而,老年患者遭受了独特的损伤,住院时间更长,出院到医疗机构的比例更高,死亡率也更高。针对老年人的护理可能会改善这种独特的与运动相关的创伤人群的预后。

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