Document Detail

Severely injured geriatric patients return to independent living: a study of factors influencing function and independence.
MedLine Citation:
PMID:  1875435     Owner:  NLM     Status:  MEDLINE    
Our previous work demonstrated that geriatric trauma patients (age greater than 65 years) consume disproportionate amounts of health care resources. In the past we hypothesized that late mortality is high, long-term outcome is poor, and return to independence is low in a severely injured geriatric population. Of 6,480 trauma admissions over 5 years, geriatric patients (n = 495) with blunt trauma injury (n = 421) and an ISS greater than 16 (n = 105) who survived until discharge (n = 61) underwent long-term follow-up (mean = 2.82 years). We surveyed 20 measures of functional ability; 10 measures of independence; availability and use of rehabilitation resources; employment history; alcohol use; support systems; and nursing home requirements. Of the 105 patients, 7 were subsequently lost to follow-up. Among the remaining 98, 44 (44.9%) died in hospital and 54 (55.1%) were discharged and interviewed. The mean age of the contacted patients was 72.6; their mean ISS was 23.3. Forty eight of 54 (88.9%) were alive at the time of interview, while 6/54 (11.1%) had died. Although only 8/48 patients regained their preinjury level of function, 32/48 (67%) returned to independent living. The 32 independent patients, those with "acceptable" outcome, were compared with an "unacceptable" outcome group composed of the 44 in-hospital deaths, the 6 late deaths, and the 16 dependent patients. Factors associated with poor outcome include a GCS score less than or equal to (p = 0.001), age greater than or equal to 75 (p = 0.004), shock upon admission (p = 0.014), presence of head injury (p = 0.03), and sepsis (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
J A van Aalst; J A Morris; H K Yates; R S Miller; S M Bass
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  31     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-26     Completed Date:  1991-09-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1096-101; discussion 1101-2     Citation Subset:  AIM; IM    
Vanderbilt University School of Medicine, Division of Trauma, Nashville, Tennessee 37212.
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MeSH Terms
Activities of Daily Living*
Age Factors
Craniocerebral Trauma / complications
Follow-Up Studies
Glasgow Coma Scale
Injury Severity Score
Retrospective Studies
Shock / etiology
Trauma Severity Indices
Wounds, Nonpenetrating / complications,  mortality,  rehabilitation*

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

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