Age-based differences in the disability of extremity injuries in pediatric and adult occupants

Gaffley, Michaela; Weaver, Ashley A.; Talton, Jennifer W.; Barnard, Ryan; Stitzel, Joel D.; Zonfrillo, Mark R.

doi:10.1080/15389588.2019.1658873

Cited by 11 publications

(16 citation statements)

References 20 publications

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“…Selected variables of interest that were continuous or ordinal (age, ISS, transportation time, and Glasgow Coma Scale) were coded as categorical variables. Age was divided into the groups 0–15 (pediatric), 16–45 (young adults), 46–60 (middle aged), 61–75 (old adults), and > 75 years (geriatric), as different age groups have different susceptibility and vulnerability to trauma [ 37 , 38 ]. Transportation time was divided into 0–20 (short), 20–45 (medium), 45–90 (long), and > 90 min (prolonged), as patients were categorized as injured in the hospital vicinity (short) and with increasingly longer transportation time (medium, long, prolonged).…”

Section: Methodsmentioning

confidence: 99%

Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study

Candefjord

Asker

Caragounis

2020

Eur J Trauma Emerg Surg

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Objective The main objective was to compare the 30-day mortality rate of trauma patients treated at trauma centers as compared to non-trauma centers in Sweden. The secondary objective was to evaluate how injury severity influences the potential survival benefit of specialized care. Methods This retrospective study included 29,864 patients from the national Swedish Trauma Registry (SweTrau) during the period 2013–2017. Three sampling exclusion criteria were applied: (1) Injury Severity Score (ISS) of zero; (2) missing data in any variable of interest; (3) data falling outside realistic values and duplicate registrations. University hospitals were classified as trauma centers; other hospitals as non-trauma centers. Logistic regression was used to analyze the effect of trauma center care on mortality rate, while adjusting for other factors potentially affecting the risk of death. Results Treatment at a trauma center in Sweden was associated with a 41% lower adjusted 30-day mortality (odds ratio 0.59 [0.50–0.70], p < 0.0001) compared to non-trauma center care, considering all injured patients (ISS ≥ 1). The potential survival benefit increased substantially with higher injury severity, with up to > 70% mortality decrease for the most critically injured group (ISS ≥ 50). Conclusions There exists a potentially substantial survival benefit for trauma patients treated at trauma centers in Sweden, especially for the most severely injured. This study motivates a critical review and possible reorganization of the national trauma system, and further research to identify the characteristics of patients in most need of specialized care.

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Section: Methodsmentioning

confidence: 99%

Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study

Candefjord

Asker

Caragounis

2020

Eur J Trauma Emerg Surg

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“…There was no significant functional differences in unilateral and bilateral pubic ramus fractures, in partial and whole weight bearing or ISS <15 and ≥15, between the two subgroups. Age was a confounding factor (Gaffley et al, 2019). The average SF-12 functional scores were 51.45 ± 9.38 and 43.52 ± 8.12 in patients aged >45 years and those ≥45 years, respectively.…”

Section: Discussionmentioning

confidence: 95%

“…Functional score results showed that patients with LC-1 pelvic fractures with nondisplaced complete sacral fractures could obtain acceptable clinical results by anterior pelvic ring fixation and conservative treatment of the sacral fractures. According to the confounding factors described in previous studies (Gaffley et al, 2019;Hoffmann, Jones & Sietsema, 2012), we compared the functional outcomes in subgroups by anterior ring fractures, postoperative weight-bearing status, age, ISS, and associated injury. There was no significant functional differences in unilateral and bilateral pubic ramus fractures, in partial and whole weight bearing or ISS <15 and ≥15, between the two subgroups.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 pelvic fractures with nondisplaced complete sacral fractures: a retrospective study

Shang

et al. 2020

PeerJ

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Purpose The aim of this study was to evaluate the feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 (LC-1) fractures with nondisplaced complete sacral fractures. Methods Patients with LC-1 type pelvic fractures with nondisplaced complete sacral fractures in the Xi’an Honghui Hospital were screened. Those who underwent surgical treatment for the anterior pelvic ring fractures and conservative treatment for the sacral factures were included in the analysis. The Majeed and Short Form-12 (SF-12) functional scores were used to evaluate these patients. Results Of the 123 patients enrolled, 108 (88%) responded to our enquiries regarding the outcome. The mean follow-up period was 18.37 months for the 108 patients who responded. The mean SF-12 functional score was 48.22 ± 9.68. The mean Majeed score was 83.47 ± 9.23, including 52 with excellent, 47 with good, seven with fair, two with poor outcomes. The SF-12 functional and Majeed scores were significantly higher in those aged <45 years or without lower limb injury than in those aged ≥45 years or with lower limb injury (P < 0.05). Conclusion Acceptable functional outcomes can be obtained for LC-1 pelvic fractures with nondisplaced complete sacral fractures by using anterior pelvic ring fixation alone.

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“…Despite the similar injuries severity in the acute phase ( Table 1 and Figure 2 ), the results showed a more significant negative evolution of the permanent outcomes in older adults ( Table 3 ). This fact is widely reported in the literature but with very little evidence [ 1 , 14 , 19 , 20 , 31 , 32 , 45 ]. Our analysis derives from the results of the application of a tool used in Portugal, the Inventory for Handicap Assessment [ 35 ] ( three-dimensional methodology of PIA ), as well as of the Portuguese permanent damage parameters used in civil law.…”

Section: Discussionmentioning

confidence: 97%

“…However, despite an absence of a significant OR, we noticed a tendency towards more days of Total Temporary Functional Deficit in the older population, in agreement with other authors [ 18 , 28 ] and as we found in our previous study without matching ISS samples ( p = 0.001) [ 25 ]. Nevertheless, we should note that seniors are more vulnerable to bed rest and reduced food intake, which should be avoided due to the effects of immobilisation (loss of strength and muscle mass, decrease in aerobic capacity, and functional decline); such effects already appear with just ten days of bed rest [ 43 , 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Are There Any Differences in Road Traffic Injury Outcomes between Older and Younger Adults? Setting the Grounds for Posttraumatic Senior Personal Injury Assessment Guidelines

Cunha-Diniz

Taveira-Gomes

Santos

et al. 2023

JCM

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Injury outcomes seem to be more severe in older than younger persons. This may make personal injury assessment (PIA) particularly difficult, mainly because of seniors’ previous health frailties. To set the grounds for seniors’ PIA guidelines, we compared an older with a younger adult population of trauma victims and, secondarily, identified differences between the groups regarding three-dimensional and medico-legal damage parameters assessment. Using a retrospective study of victims of road traffic accidents, we compared the groups (n = 239 each), assuring similar acute injury severity (ISS standardised difference = 0.01): G1 (older adults); G2 (younger adults). Logistic regression was used to estimate the odds ratio. G1 revealed higher negative consequences when considering the three-dimensional damage assessment, with more frequent and severe outcomes, being a cause of further difficulties in daily living activities, with a loss of independence and autonomy. Nevertheless, regarding the medico-legal damage parameters, permanent functional disability did not show significant differences. This study generates evidence that reveals the need to rethink the traditional methodology of PIA in older persons, giving more relevance to the real-life contexts of each person. It is essential to: obtain complete information about previous physiologic and health states, begin the medico-legal assessment as early as possible, make regular follow-ups, and perform a multidisciplinary evaluation.

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Age-based differences in the disability of extremity injuries in pediatric and adult occupants

Cited by 11 publications

References 20 publications

Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study

Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study

Feasibility of anterior pelvic ring fixation alone for treating lateral compression type 1 pelvic fractures with nondisplaced complete sacral fractures: a retrospective study

Are There Any Differences in Road Traffic Injury Outcomes between Older and Younger Adults? Setting the Grounds for Posttraumatic Senior Personal Injury Assessment Guidelines

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