Journal of Trauma and Injury

  • 제36권4호
  • /
  • Pages.329-336
  • /
  • 2023
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지
DOI QR코드

DOI QR Code

Clinical characteristics and mortality risk factors among trauma patients by age groups at a single center in Korea over 7 years: a retrospective study

  • Jonghee Han (Department of Cardiovascular and Thoracic Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Su Young Yoon (Department of Cardiovascular and Thoracic Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Junepill Seok (Department of Cardiovascular and Thoracic Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Jin Young Lee (Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Jin Suk Lee (Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Jin Bong Ye (Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Younghoon Sul (Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Seheon Kim (Department of Trauma Surgery, Trauma Center, Chungbuk National University Hospital) ;
  • Hong Rye Kim (Department of Neurosurgery, Chungbuk National University Hospital)
  • 투고 : 2023.05.15
  • 심사 : 2023.08.21
  • 발행 : 2023.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality. Methods: Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18-64 years), group B (65-79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death. Results: The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death. Conclusions: For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future.

키워드

참고문헌

  1. Statistics Korea. Causes of death statistics in 2021. Statistics Korea; 2022. 
  2. Gillies D. Elderly trauma: they are different. Aust Crit Care 1999;12:24-30.  https://doi.org/10.1016/S1036-7314(99)70509-6
  3. Grossman MD, Miller D, Scaff DW, Arcona S. When is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma 2002;52:242-6.  https://doi.org/10.1097/00005373-200202000-00007
  4. Gubler KD, Davis R, Koepsell T, Soderberg R, Maier RV, Rivara FP. Long-term survival of elderly trauma patients. Arch Surg 1997;132:1010-4.  https://doi.org/10.1001/archsurg.1997.01430330076013
  5. Keller JM, Sciadini MF, Sinclair E, O'Toole RV. Geriatric trauma: demographics, injuries, and mortality. J Orthop Trauma 2012;26:e161-5.  https://doi.org/10.1097/BOT.0b013e3182324460
  6. Caterino JM, Valasek T, Werman HA. Identification of an age cutoff for increased mortality in patients with elderly trauma. Am J Emerg Med 2010;28:151-8.  https://doi.org/10.1016/j.ajem.2008.10.027
  7. Badenes R, Taccone FS. Are you "too old" to survive a traumatic brain injury. Minerva Anestesiol 2017;83:1121-3.  https://doi.org/10.23736/S0375-9393.17.12373-4
  8. Davidson GH, Hamlat CA, Rivara FP, Koepsell TD, Jurkovich GJ, Arbabi S. Long-term survival of adult trauma patients. JAMA 2011;305:1001-7.  https://doi.org/10.1001/jama.2011.259
  9. Zhao FZ, Wolf SE, Nakonezny PA, et al. Estimating geriatric mortality after injury using age, injury severity, and performance of a transfusion: the Geriatric Trauma Outcome Score. J Palliat Med 2015;18:677-81.  https://doi.org/10.1089/jpm.2015.0027
  10. Park J, Lee Y. Predicting mortality of Korean geriatric trauma patients: a comparison between Geriatric Trauma Outcome Score and Trauma and Injury Severity Score. Yonsei Med J 2022;63:88-94.  https://doi.org/10.3349/ymj.2022.63.1.88
  11. Zhuang Y, Feng Q, Tang H, Wang Y, Li Z, Bai X. Predictive value of the Geriatric Trauma Outcome Score in older patients after trauma: a retrospective cohort study. Int J Gen Med 2022;15:4379-90.  https://doi.org/10.2147/IJGM.S362752
  12. Sadro CT, Sandstrom CK, Verma N, Gunn ML. Geriatric trauma: a radiologist's guide to imaging trauma patients aged 65 years and older. Radiographics 2015;35:1263-85.  https://doi.org/10.1148/rg.2015140130
  13. Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma 2002;53:15-20.  https://doi.org/10.1097/00005373-200207000-00004
  14. Kimbrell BJ, Velmahos GC, Chan LS, Demetriades D. Angiographic embolization for pelvic fractures in older patients. Arch Surg 2004;139:728-33.  https://doi.org/10.1001/archsurg.139.7.728
  15. Cook AC, Joseph B, Inaba K, et al. Multicenter external validation of the Geriatric Trauma Outcome Score: a study by the Prognostic Assessment of Life and Limitations After Trauma in the Elderly (PALLIATE) consortium. J Trauma Acute Care Surg 2016;80:204-9.  https://doi.org/10.1097/TA.0000000000000926
  16. Perdue PW, Watts DD, Kaufmann CR, Trask AL. Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma 1998;45:805-10.  https://doi.org/10.1097/00005373-199810000-00034
  17. van Breugel JM, Niemeyer MJ, Houwert RM, Groenwold RH, Leenen LP, van Wessem KJ. Global changes in mortality rates in polytrauma patients admitted to the ICU: a systematic review. World J Emerg Surg 2020;15:55. 
  18. Chang I, Kim H, Shin HJ, Joen WC, Park JM, Shin DW, et al. Factors contributing to mortality for patients at a newly-designated regional trauma center. J Korean Soc Traumatol 2012; 25:188-95. 
  19. Mock K, Keeley J, Moazzez A, Plurad DS, Putnam B, Kim DY. Predictors of mortality in trauma patients aged 80 years or older. Am Surg 2016;82:926-9.  https://doi.org/10.1177/000313481608201014
  20. Lustenberger T, Inaba K, Schnuriger B, et al. Gunshot injuries in the elderly: patterns and outcomes: a National Trauma Databank analysis. World J Surg 2011;35:528-34.  https://doi.org/10.1007/s00268-010-0920-7
  21. Bouamra O, Wrotchford A, Hollis S, Vail A, Woodford M, Lecky F. A new approach to outcome prediction in trauma: a comparison with the TRISS model. J Trauma 2006;61:701-10. https://doi.org/10.1097/01.ta.0000197175.91116.10