From the Department of Trauma Surgery (Touloumis, Chowdhury, Aljabri), Trauma Center, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from the Department of Clinical Research (Fitzgerald, Lodge, Ford, Mathew, Groombridge), National Trauma Research Institute, and from the Department of Surgery (Fitzgerald, Lodge, Ford, Mathew, Groombridge), Central Clinical School, Monash University, Melbourne, Australia.
Saudi Med J. 2024 Oct;45(10):1080-1086. doi: 10.15537/smj.2024.45.10.20240307.
To review the epidemiology of elderly trauma at the Kind Saud Medical City (KSMC), Riyadh, Saudi Arabia, and carry out risk-adjusted analyses to benchmark outcomes with the Alfred Hospital, Melbourne, Australia, the largest Australasian trauma service.
This retrospective study included records of injured patients (≥65 years) from the hospital trauma registries during 2022. Demographic and injury data were extracted. Risk-adjusted endpoints were: inpatient mortality and length of stay, analysed using logistic and median regression.
A total of 193 elderly patients were registered on the KSMC registry and 1233 elderly patients were registered on the Alfred Hospital registry. Kind Saud Medical City saw proportionally less major trauma (injury severity score of >12, 24.4% vs. 44.2%, <0.001) and less females (31.1% vs 44.4%, <0.001). The modal injury group was low level falls in both centres (≈60%). Discharge destination was different, particularly for patients discharged home (86.5% vs. 56%) or to a rehabilitation facility (0.5% vs. 28.2%). The risk-adjusted length of stay was 4.5 days less at the Alfred Hospital (95% CI: [3.25-5.77] days, <0.001). The odds of in-hospital death were not significantly different (OR=0.72, 95% CI: [0.36-1.47], =0.37).
Despite the different settings, low level falls were the major cause of injury in older patients. A longer length of stay in the acute hospital was identified for KSMC, however, this may be partly explained by discharge destination practices in the 2 countries.
回顾沙特阿拉伯利雅得的基德沙特医疗城（KSMC）老年创伤的流行病学，并进行风险调整分析，以基准与澳大利亚最大的澳大拉西亚创伤服务机构墨尔本阿尔弗雷德医院的结果。
这项回顾性研究包括 2022 年医院创伤登记处记录的受伤患者（≥65 岁）的记录。提取人口统计学和损伤数据。使用逻辑和中位数回归分析风险调整终点：住院死亡率和住院时间。
KSMC 登记处共登记了 193 名老年患者，Alfred 医院登记处共登记了 1233 名老年患者。KSMC 看到的严重创伤比例较低（损伤严重程度评分>12，24.4% vs. 44.2%，<0.001），女性比例较低（31.1% vs. 44.4%，<0.001）。两个中心的主要受伤类型都是低水平跌倒（≈60%）。出院目的地不同，特别是出院回家的患者（86.5% vs. 56%）或康复设施（0.5% vs. 28.2%）。Alfred 医院的风险调整住院时间短 4.5 天（95%CI：[3.25-5.77]天，<0.001）。住院期间死亡的几率没有显著差异（OR=0.72，95%CI：[0.36-1.47]，=0.37）。
尽管环境不同，但低水平跌倒仍是老年患者受伤的主要原因。KSMC 医院的急性住院时间较长，但这可能部分归因于这两个国家的出院目的地实践。
