Document Detail


Functional decline in independent elders after minor traumatic injury.
MedLine Citation:
PMID:  11136156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe injury types, patterns, and health status in independently functioning elder patients presenting to the emergency department (ED) after a minor traumatic injury; and 2) to assess short-term functional decline in this population at three-month follow-up. METHODS: This was a prospective observational study of elder patients (age > 65 years) discharged home from the ED after evaluation and treatment for an acute traumatic injury. Patients were excluded if they were not independently functioning or had an acute delirium. Type and mechanism of injury sustained during the ED visit were recorded. Functional status was assessed during the visit and three months later using activities of daily living (ADL) and instrumental activities of daily living (IADL) scores. RESULTS: One hundred six subjects were enrolled in the study. Mean age was 74.8 years. The most common injuries observed were contusion (n = 35, 33%, 95% CI = 24% to 42%), fractures (n = 28, 26%, 95% CI = 18% to 36%), lacerations (n = 20, 19%, 95% CI = 12% to 28%), and sprains (n = 12, 11%, 95% CI = 6% to 19%), which represented more than 90% of the injuries. Eighty-eight (83%) patients completed three-month follow up. Of these, 6 of 88 (6.82%, 95% CI = 3% to 14%) declined in their ADL scores and 20 of 88 (22.73%, 95% CI = 14% to 33%) declined in their IADL scores at three months. Primary injury type, specifically contusion, was more prevalent in patients who had a decline in ADL score, as compared with those who did not have a decline in ADL score (chi-square p<0.001). In addition, anatomic locations of injury were different between those patients with and without a decline in IADL scores (chi-square p = 0.008). Gender differences were also found; females were more likely to be injured by a slip, trip, or fall indoors (36 of 58, 62%) than outdoors (22 of 58, 38%); males injured by this mechanism were more likely to be injured outdoors (14 of 20, 70%) as opposed to indoors (6 of 20, 30%), chi-square p = 0.013. CONCLUSIONS: A significant proportion of functional elder patients with minor traumatic injury are at risk for short-term functional decline. Decline in ADL is related to injury type, while IADL decline is related to anatomic location of injury. Emergency physicians should consider initiating follow-up evaluation and possible intervention in highly functioning elders after minor traumatic injury.
Authors:
M J Shapiro; R A Partridge; I Jenouri; M Micalone; D Gifford
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  8     ISSN:  1069-6563     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-08     Completed Date:  2001-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  78-81     Citation Subset:  IM    
Affiliation:
Rhode Island Hospital, Division of Emergency Medicine and Injury Prevention Center, Providence, RI 02903, USA. mshapiro@lifespan.org
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Aged
Chi-Square Distribution
Comorbidity
Emergency Service, Hospital / statistics & numerical data*
Female
Geriatric Assessment
Humans
Male
Prospective Studies
Sex Distribution
Wounds and Injuries / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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