期刊
JOURNAL OF SURGICAL RESEARCH
卷 266, 期 -, 页码 261-268出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.jss.2021.02.047
关键词
Ground Level Fall; Trend; Discharge Disposition; National Trauma Data Bank; Trauma Center
类别
The study found that a high proportion of elderly trauma patients were admitted due to ground-level falls, with the incidence of falls increasing with age and plateauing after 85 years old. Although overall mortality rates decreased over time, there was an increase in adverse discharge disposition and loss of functional independence, particularly among patients admitted to non-level I trauma centers.
Introduction: Ground-level falls (GLF) are typically reported as a minor mechanism of injury; however, they represent a significant portion of hospitalized geriatric trauma patients as they can result in multisystem injury in this subset of the population. Our study aimed to analyze trends in geriatric trauma falls on the national level. Methods: We performed a 5-y (2011-2015) analysis of the American College of Surgeons Na-tional Trauma Data Bank (ACS-NTDB) and included all geriatric trauma patients (age > 65 y) who presented with GLF. GLF was identified using ICD-9 E CODES. Our outcome mea-sures were national incidence of GLF, and overall discharge disposition and trauma center level discharge disposition following GLF. We used Cochran Armitage test and multivariate regression analysis. Results: We analyzed a total of 1,017,326 geriatric trauma patients, of which 39% had had a fall as a mechanism of injury. Among those who fell, mean age was 78 +/- 7, 63% were females, and 85% were whites. The incidence of falls significantly increased over the study period, and was noted to be proportional to age, with a plateau beyond age 85 y old. The rate of discharge to SNF and/or Rehab significantly increased over the study period; however, discharge to home and mortality rates trended downwards over the study period. Discharge to SNF and/or Rehab was significantly lower among level I trauma centers compared to other level trauma centers. Conversely, discharge to home was higher in level I trauma centers compared to other level trauma centers. Conclusion: Around one in three elderly trauma patients were admitted following a GLF with an overall increased incidence of falls over time. Although overall mortality rates decreased, there was an increase in adverse discharge disposition and loss of functional independence over the study period, mostly among those admitted to non-level I trauma centers. (c) 2021 Elsevier Inc. All rights reserved.
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