Acute trauma and multiple injuries in the elderly population

被引:33
作者
Joyce, Maurice F. [1 ]
Gupta, Anupriya [1 ]
Azocar, Ruben J. [1 ]
机构
[1] Tufts Med Ctr, Dept Anesthesiol, Boston, MA 02111 USA
关键词
elderly; frailty; geriatric; orthogeriatrics; trauma; HIP FRACTURE SURGERY; EMERGENCY-DEPARTMENT; OLDER-ADULTS; FRAILTY; MORTALITY; MANAGEMENT; CARE; EPIDEMIOLOGY; PREDICTION; ANALGESIA;
D O I
10.1097/ACO.0000000000000173
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
Purpose of review Traumatic injuries in the rapidly growing elderly population pose a significant challenge to the healthcare community. These injuries are associated with significant morbidity and mortality, and as a result cause a financial burden on the medical system. Although normal decline in physiologic reserve can provide some explanation for these poor outcomes, there is significant room for improvement. This review will summarize recent literature around the evaluation and management of elderly trauma patients with a particular focus on those with hip fractures. Recent findings It is becoming increasingly evident that customized evaluation and management of elderly trauma patients is a key factor in improving outcomes. Geriatric-specific triage and assessment criteria have been developed and initial results are encouraging. In particular, the use of frailty as an assessment tool in these patients has been shown to be an independent predictor of outcomes. Further, assessment of these tools in elderly trauma patients with hip fractures has provided a wealth of information about their use and limitations. Summary Differentiated, geriatric-specific triaging, assessment and treatment pathways in the care of elderly trauma patients will ultimately lead to improvements in outcomes. These improvements have already started to be seen in the realm of orthogeriatrics.
引用
收藏
页码:145 / 150
页数:6
相关论文
共 36 条
[1]
[Anonymous], POPULATION ESTIMATES
[2]
Awargal S, 2013, MANUAL GERIATRIC ANE, P193
[3]
A Comparison of Ultrasound-guided Three-in-one Femoral Nerve Block Versus Parenteral Opioids Alone for Analgesia in Emergency Department Patients With Hip Fractures: A Randomized Controlled Trial [J].
Beaudoin, Francesca L. ;
Haran, John P. ;
Liebmann, Otto .
ACADEMIC EMERGENCY MEDICINE, 2013, 20 (06) :584-591
[4]
Maximising functional recovery following hip fracture in frail seniors [J].
Beaupre, Lauren A. ;
Binder, Ellen E. ;
Cameron, Ian D. ;
Jones, C. Allyson ;
Orwig, Denise ;
Sherrington, Cathie ;
Magaziner, Jay .
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY, 2013, 27 (06) :771-788
[5]
Risk factors for complications and in-hospital mortality following hip fractures: a study using the National Trauma Data Bank [J].
Belmont, Philip J., Jr. ;
Garcia, E'Stephan J. ;
Romano, David ;
Bader, Julia O. ;
Nelson, Kenneth J. ;
Schoenfeld, Andrew J. .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2014, 134 (05) :597-604
[6]
Perioperative Management of Elderly Patients with Hip Fracture [J].
Boddaert, Jacques ;
Raux, Mathieu ;
Khiami, Frederic ;
Riou, Bruno .
ANESTHESIOLOGY, 2014, 121 (06) :1336-1341
[7]
Postoperative Admission to a Dedicated Geriatric Unit Decreases Mortality in Elderly Patients with Hip Fracture [J].
Boddaert, Jacques ;
Cohen-Bittan, Judith ;
Khiami, Frederic ;
Le Manach, Yannick ;
Raux, Mathieu ;
Beinis, Jean-Yves ;
Verny, Marc ;
Riou, Bruno .
PLOS ONE, 2014, 9 (01)
[8]
Trauma in the Older Adult Epidemiology and Evolving Geriatric Trauma Principles [J].
Bonne, Stephanie ;
Schuerer, Douglas J. E. .
CLINICS IN GERIATRIC MEDICINE, 2013, 29 (01) :137-+
[9]
Accelerated care versus standard care among patients with hip fracture: the HIP ATTACK pilot trial [J].
Buse, Giovanna Lurati ;
Bhandari, Mohit ;
Sancheti, Parag ;
Rocha, Steve ;
Winemaker, Mitchell ;
Adili, Anthony ;
de Beer, Justin ;
Tiboni, Maria ;
Neary, John D. D. ;
Dunlop, Valerie ;
Gauthier, Leslie ;
Patel, Ameen ;
Robinson, Andrea ;
Rodseth, Reitze N. ;
Kolesar, Rick ;
Farrell, Janet ;
Crowther, Mark ;
Tandon, Vikas ;
Magloire, Patrick ;
Dokainish, Hisham ;
Joseph, Philip ;
Tomlinson, Charles W. ;
Salehian, Omid ;
Hastings, Debbie ;
Hunt, Dereck L. ;
Van Spall, Harriette ;
Cosman, Tammy L. ;
Simpson, Diane L. ;
Cowan, David ;
Guyatt, Gordon ;
Alvarado, Kim ;
Evans, W. K. ;
Mizera, Ryszard ;
Eikelboom, John ;
Cook, Deborah ;
Loeb, Mark ;
Johnstone, Jennie ;
Kearon, Clive ;
Sessler, Daniel I. ;
VanHelder, Thomas ;
Rao-Melacini, Purnima ;
Worster, Andrew ;
Patil, Atul ;
McLean, Richard ;
Macdonald, Anne-Marie ;
Badzioch, Rick ;
Devereaux, P. J. .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2014, 186 (01) :E52-E60
[10]
Evolving Prehospital, Emergency Department, and "Inpatient" Management Models for Geriatric Emergencies [J].
Carpenter, Christopher R. ;
Platts-Mills, Timothy F. .
CLINICS IN GERIATRIC MEDICINE, 2013, 29 (01) :31-+