Admission Of Seriously Injured Older Persons To Trauma Centers And Non-Trauma Hospitals

2.50
Hdl Handle:
http://hdl.handle.net/10755/161357
Type:
Presentation
Title:
Admission Of Seriously Injured Older Persons To Trauma Centers And Non-Trauma Hospitals
Abstract:
Admission Of Seriously Injured Older Persons To Trauma Centers And Non-Trauma Hospitals
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2004
Author:Scheetz, Linda, EdD, APRN, BC, CEN
Title:Assistant Professor
Contact Address:CON, Ackerson Hall , 180 University Avenue, Newark, NJ, 07102, USA
Serious injuries in older persons are often unrecognized at the scene of injury, resulting in undertriage to non-trauma center hospitals (NTCs). Since trauma centers (TCs) are better-equipped to care for the seriously injured than are NTCs, the admission of these persons to NTCs could impact their survival. This study examined the effects of age, injury severity, and injury type on TC/NTC admission and survival. Theoretical/Conceptual Framework: Trauma outcomes in older persons are influenced by age, injury severity, injury type, co-morbidities, and access to the appropriate level of care. As age increases, physiologic reserve decreases and the immune system loses its capacity to respond effectively to injury. The interaction of these physiologic effects of aging, certain co-morbidities and drugs used to treat them, injury type, and injury severity result in a blunting of the physiologic response to injury. Physiologic response to injury influences TC/NTC admission, which may mediate survival of the trauma. Subjects: Subjects included 628 motor vehicle trauma victims, age 65 and older, who sustained moderate and severe trauma and were admitted to TCs and NTCs. Methods: The following data were extracted from a statewide database of hospital discharges: age, hospital identification code, discharge status, E-code, and primary discharge diagnosis. ICDMAP translated diagnoses into injury severity scores. X2 analysis determined proportions of subjects admitted to TCs and NTCs. Logistic regression examined predictors of TC/NTC admission and survival. Results: TC admissions=43.5%; NTC admissions=56.5%. Injury severity was the strongest predictor of TC admission; odds of TC admission decreased with advancing age. Open wounds and skull fractures predicted TC admission. Advancing age and injury severity predicted non-survival. TC admission strongly predicted survival for moderately injured subjects. Conclusions: ‘Older old’ persons who sustain severe injuries and are admitted to TCs are at highest risk for non-survival.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAdmission Of Seriously Injured Older Persons To Trauma Centers And Non-Trauma Hospitalsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/161357-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Admission Of Seriously Injured Older Persons To Trauma Centers And Non-Trauma Hospitals </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Scheetz, Linda, EdD, APRN, BC, CEN</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">CON, Ackerson Hall , 180 University Avenue, Newark, NJ, 07102, USA</td></tr><tr><td colspan="2" class="item-abstract">Serious injuries in older persons are often unrecognized at the scene of injury, resulting in undertriage to non-trauma center hospitals (NTCs). Since trauma centers (TCs) are better-equipped to care for the seriously injured than are NTCs, the admission of these persons to NTCs could impact their survival. This study examined the effects of age, injury severity, and injury type on TC/NTC admission and survival. Theoretical/Conceptual Framework: Trauma outcomes in older persons are influenced by age, injury severity, injury type, co-morbidities, and access to the appropriate level of care. As age increases, physiologic reserve decreases and the immune system loses its capacity to respond effectively to injury. The interaction of these physiologic effects of aging, certain co-morbidities and drugs used to treat them, injury type, and injury severity result in a blunting of the physiologic response to injury. Physiologic response to injury influences TC/NTC admission, which may mediate survival of the trauma. Subjects: Subjects included 628 motor vehicle trauma victims, age 65 and older, who sustained moderate and severe trauma and were admitted to TCs and NTCs. Methods: The following data were extracted from a statewide database of hospital discharges: age, hospital identification code, discharge status, E-code, and primary discharge diagnosis. ICDMAP translated diagnoses into injury severity scores. X2 analysis determined proportions of subjects admitted to TCs and NTCs. Logistic regression examined predictors of TC/NTC admission and survival. Results: TC admissions=43.5%; NTC admissions=56.5%. Injury severity was the strongest predictor of TC admission; odds of TC admission decreased with advancing age. Open wounds and skull fractures predicted TC admission. Advancing age and injury severity predicted non-survival. TC admission strongly predicted survival for moderately injured subjects. Conclusions: &lsquo;Older old&rsquo; persons who sustain severe injuries and are admitted to TCs are at highest risk for non-survival. </td></tr></table>en_GB
dc.date.available2011-10-26T23:20:04Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:20:04Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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