Department of Emergency Medicine, College of Medicine, Ewha Womans University, Anyangcheonro 1071, YangChoengu, Seoul 07985, Korea; Chung-Ang University Gwangmyeong Hospital, Deokan-ro 110, Gwangmyeong-si, 14353 Gyeonggi-do, Republic of Korea.
Department of Emergency Medicine, College of Medicine, Ewha Womans University, Anyangcheonro 1071, YangChoengu, Seoul 07985, Korea; Ewha Womans University Mokdong Hospital, Anyangcheonro 1071, Yangchoengu, Seoul 07985, Republic of Korea.
Arch Gerontol Geriatr. 2023 Dec;115:105212. doi: 10.1016/j.archger.2023.105212. Epub 2023 Sep 25.
South Korea's aging population had leg to an increased number of long-term care hospitals (LTCHs), and increased transfer of older patients to emergency departments (EDs). This study investigated the epidemiological and injury profiles of LTCH patients aged ≥65 who were transferred from LTCHs to EDs due to trauma.
This retrospective study conducted between January 2014 and December 2019 in South Korea utilized data from the National Emergency Department Information System. The requirement for informed consent was waived by the IRB due to the retrospective nature of the study. Patient information was anonymized prior to analysis.
Of the 1,472,006 trauma cases aged ≥65, 14,469 came from LTCHs. Outcomes varied: 44.1% were discharged, 40.6% were admitted to general wards (GW), 5.9% to intensive care units (ICU), 2.4% to other hospitals, and 6.5% returned to LTCHs. ED length of stay (LOS) was longest in the death (410.28 ± 559.73 min) and GW admission (390.12 ± 621.71 min) groups. Falls were the main cause of injury (50.1%), and the most common fracture was femoral (71.6%). Femoral and shoulder/upper extremity fractures increased hospitalization risk only, whereas self-harm increased both hospitalization and mortality risk.
Visits to the ED by older patients from LTCH for trauma were avoidable in 50.6% of cases. Additionally, these patients had longer ED LOS and higher hospitalization rates than non-LTCH patients. Falls were the predominant mode of presentation, femoral fracture was the most common fracture among patients from LTCH.
韩国人口老龄化导致长期护理医院（LTCH）数量增加，以及更多老年患者转至急诊科（ED）。本研究调查了因创伤从 LTCH 转至 ED 的≥65 岁 LTCH 患者的流行病学和损伤特征。
本研究为回顾性研究，于 2014 年 1 月至 2019 年 12 月在韩国进行，使用了国家急诊科信息系统的数据。由于研究的回顾性性质，IRB 免除了知情同意的要求。在分析之前，对患者信息进行了匿名化。
在≥65 岁的 1,472,006 例创伤病例中，有 14,469 例来自 LTCH。结局各不相同：44.1%出院，40.6%收入普通病房（GW），5.9%收入重症监护病房（ICU），2.4%转至其他医院，6.5%返回 LTCH。ED 住院时间（LOS）最长的是死亡（410.28 ± 559.73 分钟）和 GW 入院（390.12 ± 621.71 分钟）组。跌倒为主要损伤原因（50.1%），最常见的骨折为股骨（71.6%）。股骨和肩部/上肢骨折仅增加住院风险，而自残既增加住院风险又增加死亡风险。
因创伤从 LTCH 转至 ED 的老年患者中，50.6%的病例是可以避免的。此外，这些患者的 ED LOS 较长，住院率高于非 LTCH 患者。跌倒为主要就诊模式，股骨骨折为 LTCH 患者中最常见的骨折。
