Rehabilitation Concerns in Geriatric Trauma

Tsai, Nancey Trevanian; Fakhry, Samir M.

doi:10.1007/978-1-4614-8501-8_35

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…A study from Harborview Medical Center examined 1,352 elderly patients admitted to their trauma center after a ground level fall. 9 Deaths occurred in 12% of the patients during the index admission. Of the survivors, 50% were discharged to a skilled nursing facility (SNF) and only 6% were discharged home.…”

Section: Discussionmentioning

confidence: 99%

Midlevel Providers Focusing on Geriatrics Improve Care and Outcomes of Fall-Related Injuries Among the Elderly

Holt

Testerman

2021

The American Surgeon™

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Background A rural level 1 trauma center underwent a consolidation to level III status in a new trauma network system. A dedicated group of midlevel practitioners emphasizing early mobilization, a geriatric care model, and fall prevention replaced surgical residents in the level 3 center. We hypothesized that outcomes of elderly fall-related injuries may be enhanced with midlevel providers using a geriatric-focused care model. Methods An IRB-approved trauma registry review of patients over 65 years of age with a fall-related injury admitted to a rural trauma center 1 year prior to and 1 year following a trauma center consolidation from level 1 to level III designation evaluated demographics, anticoagulant use, comorbidities, and clinical outcomes. Statistical analysis included t-test and regression analysis. Results 327 patients injured by falls were seen over a 2-year study period. The number of patients admitted with a fall-related injury and the injury severity were similar over the study period. Increasing age and anticoagulant use increased length of stay and mortality (both with P < .05). Mortality rates and patient level of independence on discharge were improved in the later period involving midlevel practitioners (both with P < .05). Discussion Trauma centers and trauma system networks face increasing challenges to provide resources and providers of care for patients injured by falls, especially for the growing elderly population. Midlevel providers focusing on geriatric clinical issues and goals may enhance care and outcomes of elderly fall-related injuries.

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Section: Discussionmentioning

confidence: 99%