老年创伤共管对多发性肋骨骨折老年患者 1 年死亡率的影响。
Impact of Geriatric Trauma Co-Management on 1-Year Mortality in Older Adults with Multiple Rib Fractures.
机构信息
Division of Geriatrics & Palliative Care, Warren Alpert Medical School, Brown University, Providence, RI.
Division of Geriatrics & Palliative Care, Warren Alpert Medical School, Brown University, Providence, RI. Center of Innovation Long Term Services and Support, Providence Veterans Administration Medical Center, Providence, RI.
出版信息
R I Med J (2013). 2023 May 1;106(4):19-24.
BACKGROUND
Rib fractures in older adults are associated with higher morbidity and mortality. Geriatric trauma co-management programs have looked at in-hospital mortality but not long-term outcomes.
METHODS
A retrospective study of multiple rib fracture patients 65 years and older (n=357), admitted from September 2012 to November 2014 comparing Geriatric trauma co-management (GTC) vs Usual Care by trauma surgery (UC). The primary outcome was 1-year mortality.
RESULTS
38.9% (139) were cared for by GTC. Compared to the UC, GTC patients were older (81.6±8.6 years vs 79±8.5) and had more comorbidities (Charlson 2.8±1.6 vs 2.2±1.6). GTC patients had 46% less chance of dying in 1-year compared to UC (HR 0.54, 95% CI [0.33-0.86]). Conclusions: GTC showed a significant reduction in 1-year mortality even though patients were overall older and more comorbid. This shows multidisciplinary teams are crucial to patient outcomes and should continue to be further explored.
背景
老年人肋骨骨折与更高的发病率和死亡率相关。老年创伤联合管理项目已经研究了院内死亡率，但没有研究长期结果。
方法
对 2012 年 9 月至 2014 年 11 月期间收治的 357 名 65 岁及以上的多发性肋骨骨折患者进行回顾性研究，比较老年创伤联合管理（GTC）与创伤外科的常规护理（UC）。主要结局是 1 年死亡率。
结果
38.9%（139 人）接受 GTC 治疗。与 UC 相比，GTC 患者年龄更大（81.6±8.6 岁 vs 79±8.5 岁），合并症更多（Charlson 2.8±1.6 vs 2.2±1.6）。GTC 患者在 1 年内死亡的风险比 UC 患者低 46%（HR 0.54，95%CI [0.33-0.86]）。
结论
尽管患者总体年龄更大，合并症更多，但 GTC 显著降低了 1 年死亡率。这表明多学科团队对患者结局至关重要，应继续进一步探索。
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