严重受伤患者的治疗现实:有没有年龄特异的差异?
Teresa Maek1, Ulrike Fochtmann1, Pascal Jungbluth2
1Department of Orthopedics and Trauma Surgery, Alfried Krupp Hospital, Alfried-Krupp-Straße 21, 45131, Essen, Germany.
BMC emergency medicine
|January 24, 2024
概括
老年患者和严重受伤的儿童接受的侵袭性治疗比成年人少. 结果不同,儿童的死亡率最低,老年患者的死亡率最低.
科学领域:
- 创伤护理研究 创伤护理研究
- 老年医学 老年医学
- 儿科急诊医学 儿科急诊医学
背景情况:
- 严重的创伤是所有年龄组的全球主要死亡原因.
- 对创伤的特定年龄反应尚未得到充分研究,尽管儿童和老年人之间存在已知的生理差异.
- 对不同年龄人口的创伤治疗和结果进行比较调查是有限的.
研究的目的:
- 分析和比较不同年龄段的严重受伤患者的治疗和结果.
- 使用匹配的三重分析来控制受伤严重程度和医院水平.
- 调查创伤管理和患者结局中的特定年龄差异.
主要方法:
- 来自DGU® (2011-2020) 创伤登记册数据的分析.
- 包括56,115名患者,其最大缩短伤害量 (MAIS) 分数在3到5之间.
- 匹配的三重分析比较儿童 (3-15岁),成年人 (20-50岁) 和老年人 (70-90岁) 基于确切的伤害严重程度和医院水平.
主要成果:
- 发现了2590个匹配的三胞胎.
- 交通事故是儿童和成人严重受伤的主要原因;老年人低跌占主导地位.
- 老年患者接受的复苏和干预较少,结果更差,死亡率更高;儿童的死亡率最低.
结论:
- 严重受伤的老年患者和儿童可能会接受较少的侵入性治疗,与具有相同伤害严重程度的成年人相比.
- 儿科和老年创伤患者之间的结果是不同的,儿童的生存率更好.
- 未来的创伤指南和研究必须明确考虑特定年龄的治疗和结果变化.
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