Yakubu Hussein A, Boakye-Yiadom Jonathan, Marfo Richmond O, Oteng Rockefeller, Oduro George
Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
Afr J Emerg Med. 2025 Sep;15(3):100883. doi: 10.1016/j.afjem.2025.05.007. Epub 2025 Jun 10.
The elderly population is rapidly increasing in sub-Saharan Africa. Yet, their trauma care needs are often overlooked, and the epidemiology of their injuries remains poorly understood. This study aimed to describe the characteristics and outcomes of injuries in elderly patients treated at an urban emergency department (ED) in Ghana. Additionally, it aimed to identify the predictors of mortality that require focused attention.
A prospective cross-sectional survey of patients ≥ 60 years presenting with traumatic injuries between November 2021 and March 2022 was conducted at the ED of Komfo Anokye Teaching Hospital (KATH), Ghana's second-largest hospital. Eligible patients were identified upon arrival in triage. Following initial resuscitation, trained research assistants obtained informed consent and collected patient data, including sociodemographic information, comorbidities, injury characteristics, and in-patient complications.
Of the 2242 ED patients evaluated, 101 (4.7 %) were included. The median age was 69 years and sex distribution was even. Hypertension (48.5 %) was the most prevalent comorbidity. Falls (52.5 %) and motor vehicle collisions (40.6 %) were the predominant injury mechanisms, and isolated lower extremity injuries (39.6 %) were the most common. The majority of injuries were mild (65.4 % had an Injury Severity Score < 9). Venous thromboembolism was the most common in-patient complication. Median length of stay was 6 days, but patients with complications stayed longer. The overall hospital mortality rate was 11.9 %. Predictors of mortality were triage score, admission Glasgow Coma Score, admission pulse rate and Kampala Trauma Score.
Geriatric injuries constitute a small fraction of trauma admissions in this hospital. Triage score, Glasgow Coma Scale, pulse rate and Kampala Trauma Score predicted mortality and could form the basis for a simple screening protocol in low-resource EDs.
撒哈拉以南非洲地区的老年人口正在迅速增加。然而，他们的创伤护理需求常常被忽视，对其受伤情况的流行病学了解仍然很少。本研究旨在描述在加纳一家城市急诊科接受治疗的老年患者的损伤特征和结果。此外，旨在确定需要重点关注的死亡预测因素。
对2021年11月至2022年3月期间在加纳第二大医院科姆福·阿诺克耶教学医院急诊科就诊的60岁及以上创伤患者进行前瞻性横断面调查。符合条件的患者在分诊时被识别出来。在初步复苏后，经过培训的研究助理获得知情同意并收集患者数据，包括社会人口统计学信息、合并症、损伤特征和住院并发症。
在评估的2242名急诊科患者中，101名（4.7%）被纳入研究。中位年龄为69岁，性别分布均匀。高血压（48.5%）是最常见的合并症。跌倒（52.5%）和机动车碰撞（40.6%）是主要的损伤机制，孤立的下肢损伤（39.6%）最为常见。大多数损伤为轻度（65.4%的损伤严重程度评分<9）。静脉血栓栓塞是最常见的住院并发症。中位住院时间为6天，但有并发症的患者住院时间更长。总体医院死亡率为11.9%。死亡预测因素为分诊评分、入院格拉斯哥昏迷评分、入院脉搏率和坎帕拉创伤评分。
老年损伤在该医院创伤入院患者中占比很小。分诊评分、格拉斯哥昏迷量表、脉搏率和坎帕拉创伤评分可预测死亡率，并可为资源匮乏的急诊科制定简单筛查方案提供依据。
