Trauma in the Geriatric Population

Maxwell, Cathy A.

doi:10.1016/j.cnc.2015.02.006

Cited by 5 publications

(2 citation statements)

References 47 publications

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“…This result was supported by triage ( p < 0.001) and trauma team activation ( p < 0.001). In a previous study it was found that older adults, even with a lower injury severity, are hospitalized for injury more often than younger adults [ 19 ]. We investigated several clinical outcomes and revealed no significant difference in both groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome and Management for Geriatric Traumatic Injury: Analysis of 2688 Cases in the Emergency Department of a Teaching Hospital in Taiwan

Chen

Yiang

et al. 2018

JCM

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Geriatric traumatic injuries in emergency departments are frequent and associated with higher mortality rates and catastrophic functional outcomes. Several prediction scores have been established to manage traumatic patients, including the shock index (SI), revised trauma score (RTS), injury severity score (ISS), trauma injury severity score (TRISS), and new injury severity score (NISS). However, it was necessary to investigate the effectiveness and efficiency of care for the geriatric traumatic population. In addition, image studies such as computed tomography and magnetic resonance imaging play an important role in early diagnosis and timely intervention. However, few studies focus on this aspect. The association between the benefit of carrying out more image studies and clinical outcomes remains unclear. In this study, we included a total of 2688 traumatic patients and analyzed the clinical outcomes and predicting factors in terms of geriatric trauma via pre-hospital and in-hospital analysis. Our evaluation revealed that a shock index ≥1 may be not a strong predictor of geriatric trauma due to the poor physical response in the aging population. This should be modified in geriatric patients. Other systems, like RTS, ISS, TRISS, and NISS, were significant in terms of predicting the clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcome and Management for Geriatric Traumatic Injury: Analysis of 2688 Cases in the Emergency Department of a Teaching Hospital in Taiwan

Chen

Yiang

et al. 2018

JCM

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“…This knowledge would prove beneficial to all members of the health-care team and family throughout the hospital course. [15][16][17][18]…”

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confidence: 99%

Patient Characteristics Associated with Comfort Care among Trauma Patients at a Level I Trauma Center

Geary

Brown

Decker

et al. 2018

The American Surgeon™

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Trauma patients admitted to the intensive care unit are a unique population with high mortality. This study aims to identify characteristics predicting the likelihood of progressing to palliative management often referred to as comfort care measures, thus enabling the trauma team to broach end-of-life decisions earlier in these patients’ care. This is a retrospective analysis of the prospectively collected New York State Trauma Registry database for a single Level I trauma center for patients admitted from 2008 to 2015. During this time, a total of 13,662 patients were admitted to the trauma service and there were 827 deaths, resulting in a crude annual mortality rate of approximately 6 per cent. Approximately one-half of the total mortalities, 404 of 827 (48.9%), were ultimately designated as comfort care. Univariate analysis identified the following risk factors for comfort care designation: advanced age, multiple comorbidities, blunt trauma mechanism, traumatic brain injury, and admission location. Multivariate analysis confirmed advanced age and traumatic brain injury. Subgroup analysis also identified advanced directives, pre-existing dementia, and bleeding disorders as significant associations with comfort care designation. The identification of factors predicting comfort care will result in improved care planning and resource utilization.

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Nursing Considerations in General Evaluation, Risk Management, and Goals of Care

Maxwell

2017

Geriatric Trauma and Acute Care Surgery

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Trauma in the Geriatric Population

Cited by 5 publications

References 47 publications

Clinical Outcome and Management for Geriatric Traumatic Injury: Analysis of 2688 Cases in the Emergency Department of a Teaching Hospital in Taiwan

Clinical Outcome and Management for Geriatric Traumatic Injury: Analysis of 2688 Cases in the Emergency Department of a Teaching Hospital in Taiwan

Patient Characteristics Associated with Comfort Care among Trauma Patients at a Level I Trauma Center

Nursing Considerations in General Evaluation, Risk Management, and Goals of Care

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