The effect of traumatic head injuries on the outcome of middle-aged and geriatric orthopedic trauma patients

被引:2
作者
Ranson, Rachel [1 ,2 ]
Esper, Garrett W. [1 ]
Woodruff, Robert [3 ]
Solasz, Sara J. [1 ]
Egol, Kenneth A. [1 ,4 ]
Konda, Sanjit R. [1 ,4 ]
机构
[1] NYU, Langone Orthopaed Hosp, New York, NY USA
[2] George Washington Univ Hosp, 900 23rd St NW, Washington, DC 20037 USA
[3] Campbell Univ, Sch Osteopath Med, Lillington, NC USA
[4] Jamaica Hosp Med Ctr, 8900 Van Wyck Expy, Queens, NY 11418 USA
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2024年 / 55卷 / 03期
关键词
Abbreviated injury score; Head injury; Traumatic; Complication; Outcomes; Geriatric; UNITED-STATES; BRAIN-INJURY; COSTS;
D O I
10.1016/j.injury.2023.111299
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: The purpose of this study is to characterize the effects of head injuries amongst the middle-aged and geriatric populations on hospital quality measures, costs, and outcomes in an orthopedic trauma setting. Methods: Patients with head and orthopedic injuries aged >55 treated at an academic medical center from October 2014 -April 2021 were reviewed for their Abbreviated Injury Score for Head and Neck (AIS-H), baseline demographics, injury characteristics, hospital quality measures and outcomes. Univariate comparative analyses were conducted across AIS-H groups with additional regression analyses controlling for confounding variables. All statistical analyses were conducted with a Bonferroni adjusted alpha. Results: A total of 1,051 patients were included. The mean age was 74 years, and median AIS-H score was 2 (range 1-6). While outcomes worsened and costs increased as AIS-H scores increased, the most drastic (and clinically relevant) rise occurs between scores 2-3. Patients who sustained a head injury warranting an AIS-H score of 3 experienced a significantly higher rate of major complications, need for ICU admission, inpatient and 1 -year mortality with longer lengths of stay and higher total costs despite no differences in demographics or injury characteristics. Regression analysis found a higher AIS-H score was independently associated with greater mortality risk. Conclusion: AIS-H scores >2 correlate with significantly worse outcomes and higher hospital costs. Concomitant head injuries impact both outcomes and direct variable costs for middle-aged and geriatric orthopedic trauma patients. Clinicians, hospitals, and payers should consider the significant effect of head injuries on the hospitalization of these patients.
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页数:5
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