Old Age as a Criterion for Trauma Team Activation

Δημητριάδης, Δημήτριος; Sava, Jack; Alo, Kathleen; Newton, Edward J.; Velmahos, George C.; Murray, James A.; Belzberg, Howard; Asensio, Juan A.; Berne, Thomas V.

doi:10.1097/00005373-200110000-00022

Cited by 230 publications

(160 citation statements)

References 5 publications

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“…As can be seen, this difference was not statistically significant despite higher mean of deceased group compared to discharged patients. However, Tornetta, Demetriades and Jameel et al have pointed out the significant role of age in mortality of trauma patients, so that these studies have reported that all cases of morbidity and mortality in trauma patients were increased with age (12)(13)(14). Our study also showed no statistically significant differences in spite of about 10-year difference in mean age of discharged and deceased subjects.…”

Section: Discussioncontrasting

confidence: 51%

Determining Prognostic Value of Serum Levels of Lactate, Bicarbonate, Base Deficit and Glucose in Mortality Rate of Trauma Patients Admitted to Emergency Department

Ghafouri

Pouraghaei

Ghffarzad

et al. 2017

IMMINV

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Introduction: Trauma is of the most important health problems in the world and major factor leading to mortality and morbidity, especially in the first four decades of life in injured people. So, we decided to examine in this study clinical symptoms and laboratory parameters in trauma patients and predictive value in determining prognosis and mortality of these patients. Materials and Method: In this descriptive study, 150 cases of multi-trauma patients admitted to the emergency department of Tabriz Imam Reza hospital were enrolled in the study. Computerized block randomization method was applied to randomize the subjects The questionnaire containing basic information in the pre-hospital phase were recorded for selected patients. As well, injury severity score (ISS) and revised trauma score (RTS) were calculated. Then, blood samples were taken from patients for testing laboratory parameters, including serum lactate level, base deficit, blood glucose, serum bicarbonate levels, BUN and Cr. The data obtained were analyzed through descriptive statistics, frequency, percentage and mean difference test and chi-square test for qualitative variables examined using the software statistical SPSS v17. The P value<0.05 was considered statistically significant. Results: mean age of patients was equal to 37.05±1.58 years. 130 patients (87.8%) were discharged after treatment and recovery and 18 patients (12.2%) died. predictive values of serum lactate cut of point was 27.65 pg/ml for serum lactate with sensitivity of 80% and specificity of 48% on admission. Conclusion: It seems that the mentioned markers alone are unable to be potent prognostic factors as predictors of mortality.

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Section: Discussioncontrasting

confidence: 51%

Determining Prognostic Value of Serum Levels of Lactate, Bicarbonate, Base Deficit and Glucose in Mortality Rate of Trauma Patients Admitted to Emergency Department

Ghafouri

Pouraghaei

Ghffarzad

et al. 2017

IMMINV

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“…However, there was a ''differentially low compliance for older trauma patients meeting physiology criteria alone.'' Demetriades et al 22 found that existing physiological criteria failed to identify a significant number of severely injured geriatric patients who had been brought to the TC. They concluded that age .…”

Section: Discussionmentioning

confidence: 99%

Geriatric Trauma Patients—Are They Receiving Trauma Center Care?

Lane

Sorondo

Kelly

2003

Academic Emergency Medicine

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Objectives: The primary purpose of this study was to evaluate whether severely injured geriatric patients were as likely to be treated at designated trauma centers (TCs) within the statewide trauma system. The secondary objective was to compare the demographic and injury characteristics of severely injured older and young patients who received care in TCs with the characteristics of those patients cared for in non-TCs. Methods: The authors reviewed files for all acute injury discharges in Pennsylvania for 1997. Injury diagnoses were mapped to Abbreviated Injury Scale (AIS) scores using ICDMAP software; the Injury Severity Score (ISS) was computed. The frequency of hospital discharges for injury from TC and non-TC hospitals in both the older (E) ($65 years) and younger (Y) (,65 years) groups were computed, and compared using chisquare testing for significance. Logistic regression was performed to assess the influence of various factors. Severity of injury was controlled for with both ISS and Maximum AIS (MAIS). Results: 107,358 patients were admitted to hospitals in the state because of injury; 8,980 had an ISS . 15; 5,855 were Y and 3,125 were E. Forty-seven percent of the Y patients received TC care compared with only 36.6% of the E patients (p , 0.001). Logistic regression analysis showed that age was a strongly negative predictor for TC care when injury severity was controlled. Conclusions: Seriously injured older patients were less likely to receive care in a trauma center than younger patients.

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“…Given the high rate of mistriage seen in age groups over 70, activating both medical and trauma practitioners to provide the initial assessment of these patients could lead to decreased rates of missed injury and medical diagnoses, and thereby prevent potentially harmful delays in diagnosis and treatment. Indeed, such recommendations have been made in the past, in trauma studies that identified increased morbidity and mortality in patients over 70 (15,16). These studies and our own findings lead us to recommend that the trauma service be activated for the evaluation and management of "found down" patients over 70 years of age upon arrival at the ED.…”

Section: Discussionmentioning

confidence: 87%