Factors Influencing Mortality in Geriatric Trauma
Journal of the Korean Society of Emergency Medicine
;
: 421-430, 1999.
Artículo
en Coreano
| WPRIM
| ID: wpr-31644
ABSTRACT
BACKGROUND:
The goal of this study is to identify the factors that predict mortality in elderly trauma patients.METHOD:
We reviewed retrospectively the medical record of 144 cases of geriatric trauma admitted to Kyungpook National University Hospital firm January 1998 to December 1998. We evaluated the general characteristics, mechanisms of injury, Revised Trauma Score(RTS), Injury Severity Score(ISS), Probability of survival(Ps) by TRISS(Trauma and Injury Severity Score) method, amount of blood transfused, preexisting disease, complications, length of stay, and mortality.RESULTS:
1. The mean age was 75.39+/-7.89 years old, and male to female ratio was 0.89 1. 2. The mechanisms of injury were primarily frills(56.3%) followed by bicycle or motorcycle(13.9%), and pedestrian injuries(13.2%) and motor vehicle accidents(6.9%). 3. The mean Glasgow Coma Scale(GCS), RTS and ISS ate 13.3+/-3.5, 7.2+/-1.4 and 14.2 +/-11.6 respectively. 4. The actual mortality rate was 18.1% (26/144). But by TRISS method, predicted mortality rate was 9.3%(12.5/144), excess mortality rate was 108% and Z score was 3.99 indicating that actual number of death exceed predicted number of death. 5. Between the survivors and nonsurvivors, the insults were significantly different as follows ; systolic blood pressure(141.9+/-28.3 vs. 116.8+/-48.7 mmHg), GCS(14.3+/-2.0 vs. 9.0 +/-5.1), RTS(7.8+/-0.7 vs 5.4+/-2.3), ISS(11.3+/-5.6 vs 27.2+/-20.2), Ps by TRISS(0.97+/-0.06 vs 0.65+/-0.37), preexisting diseases(50.8 vs 69.8%).CONCLUSION:
Geriatric patients are more likely to die after trauma than other age groups. The cause of higher actual mortality rate compared to predicted mortality rate was considered as the higher incidence of delayed death due to sepsis or multiple organ failure. In order to reduce the mortality, even with relatively stable initial vile sign, invasive hemodynamic monitoring and intensive treatment are recommended and also, prevention and treatment of nosocomial infection are very important.
Texto completo:
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Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Registros Médicos
/
Infección Hospitalaria
/
Incidencia
/
Estudios Retrospectivos
/
Mortalidad
/
Sobrevivientes
/
Coma
/
Sepsis
/
Vehículos a Motor
/
Cobertura de Afecciones Preexistentes
Tipo de estudio:
Estudio de incidencia
/
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Journal of the Korean Society of Emergency Medicine
Año:
1999
Tipo del documento:
Artículo
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