(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
İlker İNCE
(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
Mehmet Can AKSOY
(Atatürk Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Bölümü, Erzurum, Türkiye)
Yıl: 2020Cilt: 52Sayı: 1ISSN: 1308-8734 / 1308-8742Sayfa Aralığı: 1 - 5İngilizce

19 0
Comparing the Clinical Features and Trauma Scores of Trauma Patients Aged Under 65 Years with Those of Patients Aged over 65 Years in the Intensive Care Unit: A Retrospective Study for Last Ten Years
Objective: This retrospective study aimed to compare the clinical characteristics and trauma scores of Intensive Care Unit (ICU) trauma patients 65 years and older with the patients under 65 years old. Materials and Methods: Trauma patients (n=161) who stayed at least 24 hours in ICU were included. Patients younger than 65 years were included into Group 1 (n=109) and patients aged ≥65 years (n=52) were included into Group 2. Patient characteristics and trauma index scores (GCS; APACHE II score, ISS; TRISS and RTS) at ICU admission were calculated. Results: The patients in Group 2 had more comorbid disease compared with Group 1 (61.5%, 6.4%) (p=0.001). The Trauma-related Injury Severity Score score were higher in Group 1 (49.76±33.75) compared with Group 2 (35.38±34.93) (p=0.006). The APACHE II score were higher in Group 2 (20.08±7.60) compared with Group 1 (17.00±6.90) (p=0.007). The need for invasive mechanical ventilation and tracheostomy were more frequent in Group 2 trauma patients compared with those of patients in Group 1 (92.3%, 73.4%; p=0.003; 26.9%, 8.3%; p=0.002; respectively). The need for transfusion of packed red blood cell suspension (PRBC) was more frequent in Group 2 compared with Group 1 (92.3%, 55.0%; respectively) (p=0.001). The mortality rate was found to be higher in Group 2 compared with Group 1 (48.1%, 19.3%; respectively) (p=0.001). Conclusion: The elderly trauma patients have more comorbid disease, higher scores for APACHE II and lower scores for TRISS, more mechanical ventilation and tracheostomy requirements and higher mortality rate compared with young trauma patients.
DergiAraştırma MakalesiErişime Açık
  • 1. Kirshenbom D, Ben-Zaken Z, Albilya N, Niyibizi E, Bala M. Older Age, Comorbid Illnesses, and Injury Severity Affect Immediate Outcome in Elderly Trauma Patients. J Emerg Trauma Shock 2017; 10: 146-50. [CrossRef]
  • 2. Lecky F, Woodford M, Edwards A, Bouamra O, Coats T. Trauma scoring systems and databases. British Journalof Anaesthesia 2014; 113: 286-94. [CrossRef]
  • 3. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2: 81-4. [CrossRef]
  • 4. Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the Trauma Score. J Trauma 1989; 29: 623-9. [CrossRef]
  • 5. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Critical Care Medicine 1985; 13: 818-29. [CrossRef]
  • 6. Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974; 14: 187-96. [CrossRef]
  • 7. Boyd CR, Tolson MA, Copes WS: "Evaluating Trauma Care: The TRISS Method", J Trauma 1987; 27: 370-8. [CrossRef]
  • 8. Ince I, Kızılkaya M, Aksoy M, et al. Study of effectiveness of the SAPS II-III, APACHE II-IV and MPM II SCORES in the determination of prognosis of the patients in reanimation intensive care unit. Acta Medica Mediterranea 2015; 31: 127-31.
  • 9. Unlü AR, Ülger F, Dilek A, Barış S, Murat N, Sarıhasan B. Evaluation of the relationship between revised trauma score, and trauma and injury severity scores with prognosis of trauma patients in intensive care unit. J Turk Anaesth Int Care 2012; 40: 128-35. [CrossRef]
  • 10. Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score. Crit Care 2011; 15: R191. [CrossRef]
  • 11. Serviá L, Badia M, Montserrat N, Trujillano J. Severity scores in trauma patients admitted to ICU. Physiological and anatomic models. Med Intensiva. 2019; 43: 26-34. [CrossRef]
  • 12. Dharap SB, Ekhande SV. An observational study of incidence, risk factors & outcome of systemic inflammatory response & organ dysfunction following major trauma. Indian J Med Res 2017; 146: 346-53.
  • 13. Moon SH, Kim JW, Byun JH, et al. The thorax trauma severity score and the trauma and injury severity score: Do they predict in-hospital mortality in patients with severe thoracic trauma?: A retrospective cohort study. Medicine (Baltimore). 2017; 96: e8317. [CrossRef]
  • 14. Cheung A, Haas B, Ringer TJ, McFarlan A, Wong CL. Canadian Study of Health and Aging Clinical Frailty Scale: Does It Predict Adverse Outcomes among Geriatric Trauma Patients? J Am Coll Surg 2017; 225: 658-65. [CrossRef]
  • 15. Scheetz LJ. Trends in the accuracy of older person trauma triage from 2004 to 2008. Prehosp Emerg Care 2011; 15: 83-7. [CrossRef]
  • 16. Sanderson WC, Scherbov S, Gerland P. Probabilistic population aging. PLoS One 2017; 12: e0179171. [CrossRef]
  • 17. Braun BJ, Holstein J, Fritz T, et al. Polytrauma in the elderly: a review. EFORT Open Rev 2016; 1: 146-51. [CrossRef]
  • 18. Banks SE, Lewis MC. Trauma in the elderly: considerations for anesthetic management. Anesthesiol Clin 2013; 31: 127-39. [CrossRef]
  • 19. Adams SD, Holcomb JB. Geriatric trauma. Curr Opin Crit Care 2015; 21: 520-6. [CrossRef]
  • 20. Ho P, Brooy BL, Hayes L, Lim WK. Direct oral anticoagulants in frail older adults: a geriatric perspective. Semin Thromb Hemost 2015; 41: 389- 94. [CrossRef]
  • 21. Jin WYY, Jeong JH, Kim DH, et al. Factors predicting the early mortality of trauma patients. Ulus Travma Acil Cerrahi Derg 2018; 24: 532-8. [CrossRef]
  • 22. Loftus TJ, Brakenridge SC, Murphy TW, et al. Anemia and blood transfusion in elderly trauma patients. J Surg Res 2018; 229: 288-93. [CrossRef]
  • 23. Carpenter CR, Avidan MS, Wildes T, Stark S, Fowler SA, Lo AX. Predicting geriatric falls following an episode of emergency department care: a systematic review. Acad Emerg Med 2014; 21: 1069-82. [CrossRef]
  • 24. Dimitriou R, Calori GM, Giannoudis PV. Polytrauma in the elderly: specific considerations and current concepts of management. Eur J Trauma Emerg Surg 2011; 37: 539-48. [CrossRef]
  • 25. World Health Organization (WHO). Proposed Working Definition of an Older Person in Africa for the MDS Project: Definition of an Older or Elderly Person; 2013. Available from: http://www. Who. Int/healthinfo/survey/ageingde-fnolder/en/.
  • 26. Lee AT, Gagnidze A, Pan SR, et al. Preoperative Low-Dose Aspirin Exposure and Outcomes After Emergency Neurosurgery for Traumatic Intracranial Hemorrhage in Elderly Patients. Anesth Analg 2017; 125: 514-20. [CrossRef]
  • 27. Thakur RP, Banerjee A, Nikumb VB. Health Problems Among the Elderly: A Cross-Sectional Study. Ann Med Health Sci Res 2013; 3: 19-25. [CrossRef]
  • 28. Kung SC, Lin WT, Tsai TC, et al. Epidemiologic characteristics and outcomes of major trauma patients requiring prolonged mechanical ventilation. Medicine (Baltimore) 2017; 96: e9487. [CrossRef]
  • 29. Peñasco Y, González-Castro A, Rodríguez Borregán JC, et al. Limitation of life-sustaining treat ment in severe trauma in the elderly after admission to an intensive care unit. Med Intensiva 2017; 41: 394-400. [CrossRef]
  • 30. Llompart-Pou JA, Chico-Fernández M, SánchezCasado M, et al. Trauma Neurointensive Care Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC). Age-related injury patterns in Spanish trauma ICU patients. Results from the RETRAUCI. Injury 2016; 47: 61-65. [CrossRef]
  • 31. Madni TD, Ekeh AP, Brakenridge SC, et al. A comparison of prognosis calculators for geriatric trauma: A Prognostic Assessment of Life and Limitations After Trauma in the Elderly consortium study. J Trauma Acute Care Surg 2017; 83: 90-96. [CrossRef]
  • 32. Brown CV, Rix K, Klein AL, et al. A Comprehensive Investigation of Comorbidities, Mechanisms, Injury Patterns, and Outcomes in Geriatric Blunt Trauma Patients. Am Surg 2016; 82: 1055-62.
  • 33. Parreira JG, Soldá SC, Perlingeiro JA, Padovese CC, Karakhanian WZ, Assef JC. Comparative analysis of the characteristics of traumas suffered by elderly and younger patients. Rev Assoc Med Bras (1992). 2010; 56: 541-6. [CrossRef]
  • 34. Erlebach R, Pagnamenta A, Klinzing S, et al. Agerelated outcome of patients after traumatic brain injury: a single-center observation. Minerva Anestesiol 2017; 83: 1169-77.
  • 35. Abedzadeh-Kalahroudi M, Razi E, Sehat M, Asadi Lari M. Measurement of Disability and Its Predictors Among Trauma Patients: A Follow-up Study. Arch Trauma Res 2015; 4: 29393. [CrossRef]

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.