Senior Health Services (Dr Long) and Trauma Services (Ms Booza), Henry Ford Macomb Hospital, Clinton Township, Michigan; and College of Osteopathic Medicine, Michigan State University, Clinton Township (Dr Turner).
J Trauma Nurs. 2023;30(3):142-149. doi: 10.1097/JTN.0000000000000719.
Trauma centers are confronted with rising numbers of geriatric trauma patients at high risk for adverse outcomes. Geriatric screening is advocated but not standardized within trauma centers.
This study aims to describe the impact of Identification of Seniors at Risk (ISAR) screening on patient outcomes and geriatric evaluations.
This study used a pre-/postdesign to assess the impact of ISAR screening on patient outcomes and geriatric evaluations in trauma patients 60 years and older, comparing the periods before (2014-2016) and after (2017-2019) screening implementation.
Charts for 1,142 patients were reviewed. Comparing pre- to post-ISAR groups, the post-ISAR group with geriatric evaluations were older (M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69; p = .026) with higher Injury Severity Scores (M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92; p = .001). There was no significant difference in length of stay, intensive care unit length of stay, readmission rate, hospice consults, or inhospital mortality. Inhospital mortality (n = 8/380, 2.11% vs. n = 4/434, 0.92%) and length of stay in hours (M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06) down-trended in the postgroup with geriatric evaluation.
Resources and care coordination efforts can be directed toward specific geriatric screening scores to achieve optimal outcomes. Varying results were found related to outcomes of geriatric evaluations prompting future research.
创伤中心面临着越来越多的老年创伤患者，这些患者发生不良后果的风险很高。老年筛查在创伤中心得到提倡，但尚未标准化。
本研究旨在描述识别高危老年人（ISAR）筛查对患者结局和老年评估的影响。
本研究采用前后设计来评估 ISAR 筛查对 60 岁及以上创伤患者的患者结局和老年评估的影响，比较筛查实施前后（2014-2016 年和 2017-2019 年）的结果。
共回顾了 1142 例患者的病历。与 ISAR 前组相比，ISAR 后组接受老年评估的患者年龄更大（M = 82.06，SD = 9.51 岁比 M = 83.64，SD = 8.69 岁；p =.026），损伤严重程度评分更高（M = 9.22，SD = 0.69 分比 M = 9.38，SD = 0.92 分；p =.001）。两组的住院时间、重症监护病房住院时间、再入院率、临终关怀咨询和院内死亡率无显著差异。ISAR 后组接受老年评估的患者院内死亡率（n = 8/380，2.11%比 n = 4/434，0.92%）和住院时间（小时）（M = 136.49，SD = 67.09 小时比 M = 132.53，SD = 69.06 小时）呈下降趋势。
可以将资源和护理协调工作集中在特定的老年筛查评分上，以实现最佳结局。与老年评估结果相关的结果差异提示需要进一步研究。
