在老年患者中地面跌倒的伤害和结果:一项回顾性队列研究
Vincent Kan1, Wilson Huang2, Gretta Steigauf-Regan1
1UMass Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts.
The western journal of emergency medicine
|March 27, 2025
概括
经历地面跌倒的老年人在各年龄组中都有相似的受伤率. 头部和胸部受伤增加了重症监护室入院的几率,而头部和宫受伤增加了死亡风险,而不是年龄本身.
科学领域:
- 老年急救医学的医学
- 创伤外科 手术 创伤外科
- 放射学 放射学是一门学科.
背景情况:
- 地平面下跌 (GLF) 是老年人 (≥65岁) 访问急诊室 (ED) 的常见原因.
- 全身计算机断层扫描 (WBCT) 经常用于评估这个人口中的伤害.
- 了解与年龄相关的损伤模式和结果对于适当的资源配置和临床决策至关重要.
研究的目的:
- 确定老年人中发生在GLF后的创伤损伤的总比率.
- 调查伤害率和临床结果是否在各个年龄层 (65-74岁,75-84岁,85岁以上) 之间存在差异.
- 评估特定伤害与诸如重症监护室 (ICU) 入院和住院死亡率等结果之间的关联.
主要方法:
- 对638名年龄≥65岁的患者进行了回顾性队列研究,在接受WBCT的GLF后呈现出三级ED.
- 收集的数据包括人口统计,伤害类型 (胸部,内,腹内,宫),ICU入院和死亡率.
- 使用多变量逻辑回归来分析年龄,受伤和临床结果之间的关联.
主要成果:
- 18.9%的人患有持续的胸部损伤,12.5%的人患有内出血,0.8%的人患有腹内损伤.
- 头部和胸部受伤与急症监护室入院率的增加显著相关 (分别为OR 6.21和5.25).
- 头部和宫损伤与住院死亡率的增加相关 (分别为OR 3.21和3.37). 在各年龄组中没有发现受伤率或结果的显著差异.
结论:
- 在GLF后的老年人中,特定的伤害 (头部,胸部) 预测了ICU的入院, (头部,宫) 预测了死亡率,而不依赖于年龄组.
- 仅仅年龄本身并不是ICU入院或死亡率的重要预测因素,这表明临床判断应该指导决策.
- 建议对这种患者群体选择性使用WBCT,以临床评估为指导,而不是普遍应用.
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