scholarly journals Reduced Recovery Capacity After Major Trauma in the Elderly: Results of a Prospective Multicenter Registry-Based Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2356 ◽  
Author(s):  
Viola Freigang ◽  
Karolina Müller ◽  
Antonio Ernstberger ◽  
Marlene Kaltenstadler ◽  
Lisa Bode ◽  
...  

Aims: Considering the worldwide trend of an increased lifetime, geriatric trauma is moving into focus. Trauma is a leading cause of hospitalization, leading to disability and mortality. The purpose of this study was to compare the global health-related quality of life (HRQoL) of geriatric patients with adult patients after major trauma. Methods: This multicenter prospective registry-based observational study compares HRQoL of patients aged ≥65 years who sustained major trauma (Injury Severity Score (ISS) ≥ 16) with patients <65 years of age within the trauma registry of the German Trauma Society (DGU). The global HRQoL was measured at 6, 12, and 24 months post trauma using the EQ-5D-3L score. Results: We identified 405 patients meeting the inclusion criteria with a mean ISS of 25.6. Even though the geriatric patients group (≥65 years, n = 77) had a lower ISS (m = 24, SD = 8) than patients aged <65 years (n = 328), they reported more difficulties in each EQ dimension compared to patients <65 years. Contrary to patients < 65, the EQ-5D Index of the geriatric patients did not improve at 12 and 24 months after trauma. Conclusions: We found a limited HRQoL in both groups after major trauma. The group of patients ≥65 showed no improvement in HRQoL from 6 to 24 months after trauma.

2021 ◽  
pp. 000313482110505
Author(s):  
Paige C. Newman ◽  
Tawnya M. Vernon ◽  
Kellie E. Bresz ◽  
Jennifer A. T. Schwartz

Background Patients with a Trauma Injury Severity Score (TRISS) < .5 are termed “unexpected survivors.” There is scarce information published on this subset of geriatric patients whose survival is an anomaly. Methods This is a retrospective case-control study examining all geriatric patients (age ≥65) not expected to survive (TRISS<.5) in the Pennsylvania Trauma Outcome Study (PTOS) database from 2013 to 2017. Primary outcome was survival to discharge. We selected 10 clinically important variables for logistic regression analysis as possible factors that may improve survival. Results 1336 patients were included, 395 (29.6%) were unexpected survivors. Factors that improved survival odds are the following: Place of injury: street/highway (AOR:0.51; 95% CI: .36-.73, P < .001) and residential institution (AOR:0.46; 95% CI: .21-.98, P = .043); and presence of Benzodiazepines (AOR:0.49; 95% CI: .31-.77, P = .002) or ethanol (AOR:0.57; 95% CI: .34-.97, P = .040). Factors that decreased survival odds are the following: Hypotension (AOR: 8.59; 95% CI: 4.33-17.01, P < .001) and hypothermia (AOR: 1.58; 95% CI: 1.10-2.28, P = .014). Gender, race/ethnicity, blood transfusion in first 24 hours, shift of presentation to Emergency Department, place of injury (farm, industrial, recreational, or public building), use of Tetrahydrocannabinol, amphetamines or opioids, and level of trauma activation did not impact survival. Discussion Location of injury (street/highway and residential institution) and ethanol or benzodiazepine use led to a significant increased survival in severely injured geriatric patients. Hypotension and hypothermia led to decreased survival. Future studies should determine possible reasons these factors lead to survival (and identify additional factors) to focus efforts in these areas to improve outcomes in geriatric trauma.


Author(s):  
Jiyoung Song ◽  
Eunwon Lee

This study aimed to describe the health-related quality of life of elderly women with experience in fall treatment as well as to prepare basic data for the development of interventions to improve the quality of life for this group. The study was based on raw data from the 2019 Korea Community Health Survey. Using the SPSS program, the characteristics of the subjects were tested by frequency, percentage, and chi-square test. To establish the impact of fall experience on the health-related quality of life of elderly women, the OR and 95% CI were calculated using multiple logistic regression analysis. Of the 4260 people surveyed, 44.7% of the elderly women said they had a high quality of life, whereas 55.3% of the elderly women said they had a low quality of life. A younger age was associated with a better-rated health-related quality of life. Those who lived in a city and had a high level of education tended to describe a high quality of life. The quality of life was considered high by those who exercised, but low by those who were obese or diabetic. The results of this study can lead to a better understanding of the experiences of elderly women who have experienced falls, and they can be used as basic data for the development of related health programs.


2001 ◽  
Vol 13 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Yochi Shmuely ◽  
Mona Baumgarten ◽  
Barry Rovner ◽  
Jesse Berlin

Background: Depression is the most prevalent disabling psychiatric syndrome of aging and may lead to important decrements in the elderly depressed patient's health-related quality of life (HRQL). The goal of this study was to determine whether severity of chronic illness at admission, severity of depressive symptoms at admission, or living alone before admission was associated with lack of improvement in HRQL at 3 months postdischarge among elderly depressed inpatients. Methods: Subjects were 100 consecutive patients admitted to a 26-bed inpatient geriatric psychiatry unit from 1994 through 1997, who were residing in the community and were not demented. At admission, severity of depressive symptoms was assessed using the Geriatric Depression Scale and severity of chronic physical illness was measured using the Cumulative Illness Rating Scale (Geriatrics). HRQL was assessed at admission and again at 3 months postdischarge using the Medical Outcomes Study (MOS) 6-Item General Health Survey. Results: This study found large improvements in all MOS items between admission and 3 months postdischarge. Severity of chronic physical disease was negatively associated with the probability of improvement in three MOS items (role functioning, psychological functioning, and general health perceptions) whereas the severity of depressive symptoms on admission was negatively associated with the probability of improvement in role functioning, social functioning, and bodily pain. Living alone was negatively associated with social functioning but not with any of the other MOS items. Conclusion: The results of this study suggest that the inpatient treatment of depression in the elderly brings about improvements in quality of life that persist for at least 3 months follwing discharge. The patient's initial level of depression and initial level of physical health may be important factors to be considered when evaluating a patient's prognosis.


Author(s):  
Raditya Wratsangka ◽  
Rully Ayu Nirmalasari Haryadi Putri

Anemia is a global health problem with an extremely high prevalence and occurring in nearly 25% of the world population, particularly in the elderly group. Currently Indonesia is facing a rapid growth of the elderly population, with around 21 million elderly (8.2% of the total population), that is projected to increase to 33.7 million (11.8%) in the year 2025. Anemia in the elderly is frequently neglected, although the facts show that low hemoglobin concentration is an important marker of physiological decline and functional limitations. Although the factor of intrinsic aging may cause low hemoglobin concentration, anemia in the elderly is known to have a wide range w88ith regard to etiology, underlying disorders, and  possible mechanisms, such that it should be clinically followed up. Whatever its causes or underlying pathophysiological, anemia in the elderly has been proven to play a role in their morbidity and mortality, and may decrease their quality of life, that comprises all aspects of physical, mental, and social health, known as health-related quality of life (HRQoL). The impact of anemia on HRQoL has been studied in various populations, and most studies report the presence of an association between HRQoL and anemia in elderly individuals, which on the subscale level is particularly associated with physical health. Early diagnosis of anemia is important to prevent aggravation of the condition, to retard the progress of the disease, and to improve the health-related quality of life (HRQoL) of the patient. Prior to determining the treatment plan, the primary diagnosis and the comorbidities, especially treatable disorders, had better be identified first. The available data show that the overall prognosis will improve for anemia in patients with well-managed and corrected chronic disorders.


2021 ◽  
Vol 141 (5) ◽  
pp. 81-89
Author(s):  
Tran Quynh Anh ◽  
Pham Thi Thu Trang ◽  
Do Vu Minh Ha

Caring for an aging population is an emerging public health problem, and the quality of life (QoL) among the elderly is a significant concern. Our study aimed to describe the health - related quality of life (HRQoL) and factors associated with good HRQoL among the elderly in three communes of Hanam province in Vietnam. A cross - sectional design was used with a sample size of 479 participants aged 60 and above. HRQoL was measured using the SF - 36. Comparison of characteristics between those with high HRQoL and those with low HRQoL was done using Pearson chi - square tests. Results were reported using descriptive statistics and odds ratios with 95% CI (Confidence Interval). Many of the elderly had moderate HRQoL (41.3%), and elderly men were more likely to have higher QoL in terms of physical health and psychological health than elderly women. Our findings also indicated that some factors including older age, low educational level, those not living with their spouse, poor financial condition, having more than two health problems and possessing unhealthy drinking behaviors were significantly positive associated with HRQoL. Findings suggest interventions are needed to improve the quality of life among the elderly in rural areas of Vietnam.


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