Objectives: The aims were to: 1) describe the seriously injured older adult; 2) characterize and compare the differences in injury characteristics and outcomes in three subgroups of seriously injured older adults: 65-74 years, 75-84 years, and >85 years of age; 3) identify risk factors for death, complications, and discharge placement at hospital discharge.Design: A retrospective secondary analysis of a statewide trauma data set from 1988-1997.Setting: Data submitted from all designated trauma centers in Pennsylvania.Participants: The data set yielded 38,707 patients with a mean age of 77.5 years with serious injury (mean number of injuries = 3.6, mean number of body systems involved = 2).Measurements: Key outcomes were mortality, complications, and discharge placement. Abbreviated Injury Score categorized injuries and Injury Severity Score (ISS) quantified anatomic severity of injury.Results: Mortality was 10%. Mean length of stay 11.5 days. 52.2% of survivors were discharged home and 25.4% to a skilled nursing facility. Injury severity, total number of injuries, complications and increasing age were predictors of mortality (p<.01). The presence of pre-existing co-morbid medical conditions increased the odds of experiencing a complication over three-fold. Increasing age, total number of injuries, injury to extremities or abdominal contents, injuries due to falls, and lower functional level predicted discharge to a skilled nursing facility (p<.01).Conclusions: Traumatic injury in older adults are typically multisystem, life-threatening, and affects older adults of all ages. The standard ISS does not fully capture the potential for mortality in older adults and does not predict discharge placement. The majority of older adults survive multisystem injury. Our findings indicate the need to examine outcomes beyond mortality and to make the identification and management of co-morbid conditions a priority. A geriatric consultation service could be an important additional to the interdisciplinary trauma team.
AbstractObjectives: The aims were to: 1) describe the seriously injured older adult; 2) characterize and compare
This article describes the efforts undertaken during the past five years for the Georgia Board of Pardons and Paroles to develop a method for assessing parolee risk to inform the supervision level assignments of Georgia's 23,000 active parolees. The project resulted in an actuarial risk assessment method based on the analysis of over 6,000 parolees. Historically, officers conducted pencil-and-paper assessments on all new parolees entering supervision and reassessments every six months thereafter. The new instruments are automated—offender risk is derived through the execution of computerized programs that access both prison and parole data systems. Parolee risk scores are updated daily, incorporating the dynamics of daily correctional supervision progress or failure, and are provided to parole officers through web-based reports and e-mail.
Although home visits play a major role in community supervision, little is known about what transpires—what is discussed and with whom the discussion is held. This study addresses that void by qualitatively analyzing case notes of home visits with high-risk parolees who entered supervision in 2008, 2010, or 2012 and exited between 2011 and 2013. Officers’ written comments describing 81,732 home visits were analyzed to uncover discussion themes, tones, and the parties contacted. Of the 12 themes identified, most conversations included parolee contact with the justice system, housing, and employment. Analysis of the tone of comments as neutral, positive, or negative suggested that nearly nine out of 10 notes were neutral containing simple descriptions of the parolee’s behavior and status. While home visit interactions were primarily with parolees, parents/grandparents were the second most mentioned participants. Implications for supervision through the lens of therapeutic jurisprudence are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.