Cunha-Diniz Flávia, Taveira-Gomes Tiago, Santos Agostinho, Teixeira José Manuel, Magalhães Teresa
Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
J Clin Med. 2023 Mar 17;12(6):2353. doi: 10.3390/jcm12062353.
Injury outcomes seem to be more severe in older than younger persons. This may make personal injury assessment (PIA) particularly difficult, mainly because of seniors' previous health frailties. To set the grounds for seniors' PIA guidelines, we compared an older with a younger adult population of trauma victims and, secondarily, identified differences between the groups regarding and medico-legal damage parameters assessment. Using a retrospective study of victims of road traffic accidents, we compared the groups (n = 239 each), assuring similar acute injury severity (ISS = 0.01): G1 (older adults); G2 (younger adults). Logistic regression was used to estimate the odds ratio. G1 revealed higher negative consequences when considering the damage assessment, with more frequent and severe outcomes, being a cause of further difficulties in daily living activities, with a loss of independence and autonomy. Nevertheless, regarding the medico-legal damage parameters, did not show significant differences. This study generates evidence that reveals the need to rethink the traditional methodology of PIA in older persons, giving more relevance to the real-life contexts of each person. It is essential to: obtain complete information about previous physiologic and health states, begin the medico-legal assessment as early as possible, make regular follow-ups, and perform a multidisciplinary evaluation.
与年轻人相比,老年人的损伤后果似乎更为严重。这可能会使人身伤害评估(PIA)变得尤为困难,主要是因为老年人先前存在健康脆弱问题。为了为老年人PIA指南奠定基础,我们比较了老年和年轻成年创伤受害者群体,其次,确定了两组在损伤和法医学损害参数评估方面的差异。通过对道路交通事故受害者进行回顾性研究,我们比较了两组(每组n = 239),确保急性损伤严重程度相似(损伤严重度评分[ISS]=0.01):G1组(老年人);G2组(年轻人)。采用逻辑回归估计优势比。在考虑损伤评估时,G1组显示出更高的负面后果,结果更频繁、更严重,导致日常生活活动进一步困难,丧失独立性和自主性。然而,关于法医学损害参数,两组未显示出显著差异。本研究提供的证据表明,有必要重新思考老年人PIA的传统方法,更加关注每个人的现实生活背景。以下几点至关重要:获取有关先前生理和健康状况的完整信息,尽早开始法医学评估,定期进行随访,并进行多学科评估。