학술논문

Geriatric All-Terrain Vehicle Trauma: An Unhelmeted and Severely Injured Population.
Document Type
Article
Source
Journal of Surgical Research. Feb2022, Vol. 270, p555-563. 9p.
Subject
*ABDOMINAL injuries
*HEAD injuries
*TRAUMA centers
*ALL terrain vehicles
Language
ISSN
0022-4804
Abstract
• Geriatric All-terrain vehicle trauma patients suffered higher mortality, more severe injury, and longer hospital stays than younger adults. • Geriatric patients also have a distinct injury pattern with more thoracic, spine, and less abdominal injuries. • Age ≥65 independently increased the risk of both severe injury and mortality after All-terrain vehicle trauma. All-terrain vehicle (ATV) use is widespread, however, little is known about injury patterns and outcomes in geriatric patients. We hypothesized that geriatric patients would have distinct and more severe injuries than non-geriatric adults after ATV trauma. A retrospective cohort study was performed using the National Trauma Databank comparing non-geriatric (18-64) and geriatric adults (≥65) presenting after ATV trauma at Level 1 and 2 trauma centers from 2011 to 2015. Demographic, admission, and outcomes data were collected, including injury severity score (ISS), abbreviated injury scale (AIS) score, discharge disposition, and mortality. We performed univariate statistical tests between cohorts and multiple logistic regression models to assess for risk factors associated with severe injury (ISS>15) and mortality. 23,568 ATV trauma patients were identified, of whom 1,954 (8.3%) were geriatric. Geriatric patients had higher rates of severe injury(29.2 v 22.5%,p<0.0001), and thoracic (55.2 v 37.8%,p<0.0001) and spine (31.5 v 26.0%,p<0.0001) injuries, but lower rates of abdominal injuries (14.6 v 17.9%,p<0.001) as compared to non-geriatric adults. Geriatric patients had overall lower head injury rates (39.2 v 42.1%,p=0.01), but more severe head injuries (AIS>3) (36.2 vs 30.2%,p<0.001). Helmet use was significantly lower in geriatric patients (12.0 v 22.8%,p<0.0001). On multivariate analysis age increased the odds for both severe injury (OR 1.50, 95% CI 1.31-1.72, p<0.0001) and mortality (OR 5.07, 95% CI 3.42-7.50, p<0.0001). While severe injury and mortality after ATV trauma occurred in all adults, geriatric adults suffered distinct injury patterns and were at greater risk for severe injury and mortality. [ABSTRACT FROM AUTHOR]