Penetrating torso injuries in older adults: increased mortality likely due to “failure to rescue”
European Journal of Trauma and Emergency Surgery, ISSN: 1615-3146, Vol: 41, Issue: 6, Page: 657-663
2015
- 9Citations
- 19Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations9
- Citation Indexes9
- CrossRef7
- Captures19
- Readers19
- 19
Article Description
Purpose: Approximately 8 % of injuries in the elderly are from penetrating mechanisms. The natural history of potentially survivable penetrating torso wounds in the elderly is not well studied. Older adults with penetrating injuries to the torso may have worse outcomes than matched, younger patients due to a failure to rescue after complications. Methods: A retrospective chart review of all patients ≥55 (older) with a penetrating injury (GSW or SW) to the torso over 20 years was performed. All patients with a maximum AIS chest or abdomen >1 and <6 were included. A matched cohort (mechanism, AIS chest and abdomen, ISS and sex) of patients between the ages of 20–40 years (young) was created (3 young, 1 older). Differences in hemodynamics, complications, length of stay and mortality were analyzed. Results: 105 older met inclusion criteria were compared to 315 young patients. Hemodynamic status was similar between the groups. Older patients required ICU care more often than younger patients, p < 0.05. Older patients required longer ICU stays, p < 0.001 and longer hospitalizations, p = 0.0012. More older patients (41.0 %) suffered post-injury complications compared to the young (26.4 %), p = 0.005. Older patients who suffered a complication had a higher mortality (30.2 %) than the young after a complication (10.8 %), p = 0.007. Conclusions: While uncommon, penetrating injuries to older adults are associated with higher rates of post-injury complications and increased mortality. This may represent a “failure to rescue” and represent an opportunity for improved post-injury care in older adults who suffer potentially survivable penetrating torso injuries.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84949086173&origin=inward; http://dx.doi.org/10.1007/s00068-014-0491-7; http://www.ncbi.nlm.nih.gov/pubmed/26038012; http://link.springer.com/10.1007/s00068-014-0491-7; https://dx.doi.org/10.1007/s00068-014-0491-7; https://link.springer.com/article/10.1007/s00068-014-0491-7
Springer Science and Business Media LLC
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