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1
Geriatric trauma triage: optimizing systems for older adults-a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee.老年创伤分诊:优化老年人医疗系统——美国创伤外科协会老年创伤委员会出版物
Trauma Surg Acute Care Open. 2024 Jul 16;9(1):e001395. doi: 10.1136/tsaco-2024-001395. eCollection 2024.
2
Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.老年患者特异性分诊标准在识别受伤老年人对创伤中心护理的需求方面比标准成人标准更敏感。
Ann Emerg Med. 2015 Jan;65(1):92-100.e3. doi: 10.1016/j.annemergmed.2014.04.019. Epub 2014 Jun 6.
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Evidence-based review of trauma center care and routine palliative care processes for geriatric trauma patients; A collaboration from the American Association for the Surgery of Trauma Patient Assessment Committee, the American Association for the Surgery of Trauma Geriatric Trauma Committee, and the Eastern Association for the Surgery of Trauma Guidelines Committee.创伤中心护理和老年创伤患者常规姑息治疗流程的循证综述;美国创伤外科学会患者评估委员会、美国创伤外科学会老年创伤委员会和东部创伤外科学会指南委员会的合作。
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JBI Libr Syst Rev. 2012;10(58):4610-4621. doi: 10.11124/jbisrir-2012-429.
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Effect of Geriatric-Specific Trauma Triage Criteria on Outcomes in Injured Older Adults: A Statewide Retrospective Cohort Study.老年特异性创伤分诊标准对老年受伤患者结局的影响:一项全州范围的回顾性队列研究。
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Building Geriatric Trauma Programs in Resource-Constrained Environments: Trauma Quality Improvement Program Guideline Implementation at Two Safety Net Hospitals in Southern California.在资源有限的环境下建立老年创伤项目:南加州两家社区医院创伤质量改进项目指南的实施。
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Development of statewide geriatric patients trauma triage criteria.制定全州老年创伤患者分诊标准。
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Do elderly trauma patients receive the required treatment? Epidemiology and outcome of geriatric trauma patients treated at different levels of trauma care.老年创伤患者是否接受了所需的治疗?不同创伤救治水平下老年创伤患者的流行病学和结局。
Eur J Trauma Emerg Surg. 2020 Dec;46(6):1463-1469. doi: 10.1007/s00068-019-01285-0. Epub 2019 Dec 16.
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Prehosp Emerg Care. 2012 Jul-Sep;16(3):323-8. doi: 10.3109/10903127.2012.682701. Epub 2012 May 1.

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Mortality in Moderate to Severe Traumatic Brain Injury in Elderly Polytrauma Patients at a European Level 1 Trauma Centre-A Retrospective Cohort Study.欧洲一级创伤中心老年多发伤患者中重度创伤性脑损伤的死亡率——一项回顾性队列研究
J Clin Med. 2025 May 29;14(11):3843. doi: 10.3390/jcm14113843.
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Redefining Trauma Triage for Elderly Adults: Development of Age-Specific Guidelines for Improved Patient Outcomes Based on a Machine-Learning Algorithm.重新定义老年人的创伤分诊:基于机器学习算法制定改善患者预后的特定年龄指南。
Medicina (Kaunas). 2025 Apr 23;61(5):784. doi: 10.3390/medicina61050784.
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Predictive Limitations of the Geriatric Trauma Outcome Score: A Retrospective Analysis of Mortality in Elderly Patients with Multiple Traumas and Severe Traumatic Brain Injury.老年创伤结局评分的预测局限性:对老年多发伤和重度创伤性脑损伤患者死亡率的回顾性分析
Diagnostics (Basel). 2025 Feb 28;15(5):586. doi: 10.3390/diagnostics15050586.
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Injury patterns and patient outcomes of abdominal trauma in the elderly population: a 5-year experience of a Major Trauma Centre.老年人群腹部创伤的损伤模式与患者预后:一家大型创伤中心的5年经验
Eur J Trauma Emerg Surg. 2025 Mar 12;51(1):130. doi: 10.1007/s00068-025-02807-9.
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Predictors of prolonged hospitalization among geriatric trauma patients using the modified 5-Item Frailty index in a Middle Eastern trauma center: an 11-year retrospective study.在中东一家创伤中心使用改良的5项衰弱指数预测老年创伤患者延长住院时间:一项11年的回顾性研究
Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):82. doi: 10.1007/s00068-024-02742-1.

本文引用的文献

1
Systematic review: What is the impact of triage implementation on clinical outcomes and process measures in low- and middle-income country emergency departments?系统评价:分诊实施对低收入和中等收入国家急诊科临床结局及过程指标有何影响?
Acad Emerg Med. 2024 Feb;31(2):164-182. doi: 10.1111/acem.14815. Epub 2023 Nov 4.
2
Geriatric trauma, frailty, and ACS trauma center verification level: Are there any correlations with outcomes?老年创伤、虚弱与 ACS 创伤中心验证级别:与结局是否存在相关性?
Injury. 2024 Jan;55(1):110972. doi: 10.1016/j.injury.2023.110972. Epub 2023 Aug 7.
3
Implementation of advanced triage in the Emergency Department of high complexity public hospital: Research protocol.高级分诊在高复杂度公立医院急诊科的实施:研究方案。
Nurs Open. 2023 Jun;10(6):4101-4110. doi: 10.1002/nop2.1622. Epub 2023 Jan 31.
4
Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial.创伤特异性虚弱指数的前瞻性验证与应用:美国创伤外科协会多机构观察性试验的结果
J Trauma Acute Care Surg. 2023 Jan 1;94(1):36-44. doi: 10.1097/TA.0000000000003817. Epub 2022 Oct 17.
5
National guideline for the field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2021.国家受伤患者现场分类指南:国家现场分类专家小组 2021 年的建议。
J Trauma Acute Care Surg. 2022 Aug 1;93(2):e49-e60. doi: 10.1097/TA.0000000000003627. Epub 2022 Apr 27.
6
Developing a National Trauma Research Action Plan: Results from the geriatric research gap Delphi survey.制定国家创伤研究行动计划:老年研究差距德尔菲调查结果。
J Trauma Acute Care Surg. 2022 Aug 1;93(2):209-219. doi: 10.1097/TA.0000000000003626. Epub 2022 Apr 8.
7
Field Trauma Triage among Older Adults: A Cost-Effectiveness Analysis.老年人创伤现场分诊:成本效益分析。
J Am Coll Surg. 2022 Feb 1;234(2):139-154. doi: 10.1097/XCS.0000000000000025.
8
Evaluation of elderly specific pre-hospital trauma triage criteria: a systematic review.老年特定院前创伤分诊标准评估:系统评价。
Scand J Trauma Resusc Emerg Med. 2021 Aug 30;29(1):127. doi: 10.1186/s13049-021-00940-z.
9
Making your geriatric and palliative programs a strength: TQIP guideline implementation and the VRC perspective.将您的老年医学和姑息治疗项目打造为优势:TQIP指南的实施及VRC视角
Trauma Surg Acute Care Open. 2021 Jul 15;6(1):e000677. doi: 10.1136/tsaco-2021-000677. eCollection 2021.
10
Describing the density of high-level trauma centers in the 15 largest US cities.描述美国15个最大城市中高级创伤中心的密度。
Trauma Surg Acute Care Open. 2020 Oct 9;5(1):e000562. doi: 10.1136/tsaco-2020-000562. eCollection 2020.

老年创伤分诊:优化老年人医疗系统——美国创伤外科协会老年创伤委员会出版物

Geriatric trauma triage: optimizing systems for older adults-a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee.

作者信息

Egodage Tanya, Ho Vanessa P, Bongiovanni Tasce, Knight-Davis Jennifer, Adams Sasha D, Digiacomo Jody, Swezey Elisabeth, Posluszny Joseph, Ahmed Nasim, Prabhakaran Kartik, Ratnasekera Asanthi, Putnam Adin Tyler, Behbahaninia Milad, Hornor Melissa, Cohan Caitlin, Joseph Bellal

机构信息

Surgery, Cooper University Health Care, Camden, New Jersey, USA.

Surgery, MetroHealth Medical Center, Cleveland, Ohio, USA.

出版信息

Trauma Surg Acute Care Open. 2024 Jul 16;9(1):e001395. doi: 10.1136/tsaco-2024-001395. eCollection 2024.

DOI:10.1136/tsaco-2024-001395
PMID:39021732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11253746/
Abstract

BACKGROUND

Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.

METHODS

We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older patient, evaluating existing literature and guidelines. Opportunities for improvement or standardization were identified.

RESULTS

Opportunities for improved geriatric trauma triage exist in the pre-hospital setting, in the trauma bay, and continue after admission. They may include physiologic criteria, biochemical markers, radiologic criteria and even age. Recent Trauma Quality Improvement Program (TQIP) Best Practices Guidelines for Geriatric Trauma Management published in 2024 support these findings.

CONCLUSION

Trauma systems must adjust to provide optimal care for older adults. Further investigation is required to provide pertinent guidance.

摘要

背景

老年创伤患者在美国的人口中所占比例日益增加,跌倒发生率很高,并且与年轻患者相比,其发病率和死亡率更高。在优化该群体的治疗结果时,需要考虑可用资源,这存在显著差异和挑战。本手稿简要总结了局部和全国的实践情况,包括老年创伤分诊的相关更新内容,旨在综合研究结果并为进一步调查提供指导。

方法

我们在美国老年患者护理的多个阶段对老年分诊进行了综述,评估现有文献和指南。确定了改进或标准化的机会。

结果

在院前环境、创伤病房以及入院后都存在改善老年创伤分诊的机会。这些机会可能包括生理标准、生化标志物、放射学标准甚至年龄。2024年发布的最新创伤质量改进计划(TQIP)老年创伤管理最佳实践指南支持了这些发现。

结论

创伤系统必须做出调整,以便为老年人提供最佳护理。需要进一步调查以提供相关指导。