Epidemiology and outcomes of older trauma patients in Singapore: A multicentre study

被引：6

作者：

Chua, Mui Teng ^{[1
,2
,4
]}

Pan, Darius Shaw Teng ^{[1
]}

Lee, Ming Zhou ^{[1
]}

Thajudeen, Mohammed Zuhary ^{[3
]}

Rahman, Mohamed Madeena Faizur ^{[3
]}

Sheth, Irfan Abdulrahman ^{[3
]}

Ong, Victor Yeok Kein ^{[1
,2
]}

Tang, Jonathan Zhe Ying ^{[1
,2
]}

Wee, Choon Peng Jeremy ^{[3
]}

Sen Kuan, Win ^{[1
,2
]}

机构：

[1] Natl Univ Hlth Syst, Natl Univ Hosp, Emergency Med Dept, Singapore, Singapore

[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, Singapore

[3] Singapore Gen Hosp, Dept Emergency Med, Singapore, Singapore

[4] Natl Univ Singapore Hosp, Emergency Med Dept, 9 Lower Kent Ridge Rd, Level 4, Singapore 119085, Singapore

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2022年 / 53卷 / 10期

关键词：

Geriatric trauma; Trauma severity indices; Polypharmacy; COMORBIDITY-POLYPHARMACY SCORE; GERIATRIC TRAUMA; INCREASED MORTALITY; BRAIN-INJURY; AGE;

D O I：

10.1016/j.injury.2022.08.018

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: An ageing population has caused rising trauma cases amongst older patients. Multiple co -morbidities, polypharmacy and limited reserves predispose them to poorer outcomes following a trau-matic event. The Comorbidity Polypharmacy Score (CPS) has been found to predict outcomes and mor-tality in older trauma patients, but has not been studied in Asians.Aim: We aim to describe the epidemiological characteristics of older trauma patients and explore the association of CPS on clinical outcomes.Methods: We conducted a retrospective observational study using data from the trauma registries of 2 tertiary trauma centres. Patients aged 45 years and above attending the emergency departments (EDs) from January 2011 to December 2015 with traumatic injuries (Injury Severity Score [ISS] of 9 and above) were included. Demographics, clinical data including number of comorbidities and medications used were collected to calculate the CPS. Outcomes of mortality, ED disposition and hospital discharge venue were examined.Results: There were 4,522 patients (median age 70 years; males 53.8%), with majority sustaining Tier 2 injuries (ISS 9 to 15; 68.9%). Falls were the predominant mechanism for those aged above 60 years and above (76%). Median CPS was 6 (interquartile range [IQR] 1 to 11). Amongst patients 75 years and older, 56% comprised the moderate to morbid CPS groups (CPS >= 8). Overall mortality was 8.4%; patients above 75 years had longer median length of stay (10 versus 7.1-8.9 days in other ages). Male gender (adjusted odds ratio [aOR] 1.51; 95% confidence interval [CI] 1.12-2.02), increasing age (aOR 1.04; 95% CI 1.03-1.05), injury to abdomen (aOR 3.24; 95% CI 1.93-5.45) and severe CPS category (aOR 1.88; 95% CI 1.23-2.89) were associated with increased odds of death. Increasing age and moderate CPS category increased odds of discharge to a rehabilitation (aOR for age 1.03, 95% CI 1.02-1.04; aOR for moderate CPS 1.72, 95% CI 1.43-2.07) or long-term care facility (aOR for age 1.05, 95% CI 1.03-1.06; aOR for CPS 1.60, 95% CI 1.10- 2.32). Conclusion: CPS predicted mortality and discharge to a rehabilitation or care facility in this urban, ageing Asian population. Its use may aid future trauma research and needs assessments in such patients.(c) 2022 Elsevier Ltd. All rights reserved.

引用

页码：3149 / 3155

页数：7