在银色海中溺水:老年患者比例对创伤结果的影响
Sebastian Boland1, Liling Lu2, Tamara Byrd1
1Division of Trauma and General Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Surgery
|September 15, 2025
概括
当老年患者的比例超过65%时,所有患者的创伤中心结果都会恶化. 高老年患者数量可能会压倒创伤中心,影响老年人和非老年患者的死亡率.
科学领域:
- 创伤外科 手术 创伤外科
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在创伤护理中建立的体积-结果关系对于老年患者来说是复杂的.
- 越来越多的老年人群提出了关于创伤中心容量的潜在临界点的问题.
- 了解老年患者比例对结果的影响对于创伤系统规划至关重要.
研究的目的:
- 评估老年患者与创伤总体相比的比例是否会影响患者的治疗结果.
- 确定老年患者体积可能对创伤中心性能产生负面影响的潜在门.
- 分析老年患者比例对死亡率的非线性影响.
主要方法:
- 从2017-2021年对成人创伤患者 (>15岁) 的回顾性队列研究.
- 在总成年患者体积中计算中心水平的年老年人比例.
- 用于评估老年人比例和死亡率之间的非线性关系的一般化添加混合模型,经过调整以考虑混因素.
主要成果:
- 增加老年人比例改善了老年患者的死亡率,达到总体量的65%,之后趋于平稳.
- 非老年患者的死亡率开始增加,老年患者的比例为61%.
- 更高的老年患者比例与非老年患者死亡率的增加有关,特别是考虑到老年伴随性疾病时.
结论:
- 中心水平的老年患者比例显著预测了老年患者和非老年患者的创伤结果.
- 高的老年人比例可能表明中心被压倒,导致体积-结果效益下降,所有人的死亡率增加.
- 这些发现支持创伤系统规划,以优化对不同患者群体的护理.
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