Erden Melike, Halhalli Huseyin Cahit, Ozbek Asim Enes
University of Health Sciences, Kocaeli Derince Training and Research Hospital, Department of Emergency Medicine - Kocaeli, Turkey.
Rev Assoc Med Bras (1992). 2024 Sep 30;70(10):e20240606. doi: 10.1590/1806-9282.20240606. eCollection 2024.
Falls are a serious cause of morbidity and mortality among older people. One of the underlying causes of falls is dehydration. Therefore, ultrasonography has become an essential tool for evaluating volume status in the emergency department. However, the effect of volume status on falls in older people has not been evaluated before. The aim of this study was to determine the relationship between the inferior vena cava collapsibility index and the injury severity score in older patients who presented with fall-related injuries to the emergency department.
A total of 66 patients were included in the study. The injury severity score was used as the trauma severity score, and the Edmonton Frail Scale was used as the frailty scale. Volume status was evaluated with inferior vena cava collapsibility index. The primary outcome measure was defined as the correlation between inferior vena cava collapsibility index and injury severity score. Secondary outcome measures were defined as the effect of inferior vena cava collapsibility index and injury severity score on hospitalization and mortality.
There was no significant correlation between injury severity score and inferior vena cava collapsibility index (p=0.342). Neither inferior vena cava collapsibility index nor injury severity score was an indicator of the mortality of these patients. However, injury severity score was an indicator of hospitalization. The mean Edmonton Frail Scale score was an indicator of mortality among older people who experienced falls (p=0.002).
Inferior vena cava collapsibility index cannot be used to predict trauma severity in older patients who have experienced falls admitted to the emergency department.
跌倒在老年人中是导致发病和死亡的严重原因。跌倒的潜在原因之一是脱水。因此,超声检查已成为急诊科评估容量状态的重要工具。然而,容量状态对老年人跌倒的影响此前尚未得到评估。本研究的目的是确定在因跌倒相关损伤就诊于急诊科的老年患者中,下腔静脉塌陷指数与损伤严重程度评分之间的关系。
本研究共纳入66例患者。损伤严重程度评分用作创伤严重程度评分,埃德蒙顿虚弱量表用作虚弱程度量表。通过下腔静脉塌陷指数评估容量状态。主要结局指标定义为下腔静脉塌陷指数与损伤严重程度评分之间的相关性。次要结局指标定义为下腔静脉塌陷指数和损伤严重程度评分对住院和死亡率的影响。
损伤严重程度评分与下腔静脉塌陷指数之间无显著相关性(p = 0.342)。下腔静脉塌陷指数和损伤严重程度评分均不是这些患者死亡率的指标。然而,损伤严重程度评分是住院的一个指标。平均埃德蒙顿虚弱量表评分是跌倒老年患者死亡率的一个指标(p = 0.002)。
下腔静脉塌陷指数不能用于预测因跌倒入住急诊科的老年患者的创伤严重程度。