Growing problem: frailty in midlife adult trauma patients in the USA.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Injury Prevention Pub Date : 2025-01-07 DOI:10.1136/ip-2024-045436
Colleen Bloeser, Jacklyn Maye Engelbart, Patrick Ten Eyck, James C Torner, Colette Galet, Dionne A Skeete
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Abstract

Background: Unintentional falls are the greatest cause of injury-related hospitalisation in adult patients. Frailty is an important contributor to fall risk and poor outcomes in both midlife and older adult trauma patients. Despite this, the incidence of frailty remains understudied among midlife adults, and the CDC fall screening guidelines are limited to older adults. Here, we assessed the incidence of frailty among midlife and older trauma patients in the USA.

Methods: This was a retrospective study using the Trauma Quality Improvement Program database in midlife (aged 50-64 years) and older adult (aged 65 years and older) trauma patients from 2012 to 2021. Frailty was assessed using the five-item Modified Frailty Index. The adjusted change of frailty incidence over the study period was evaluated via Poisson regression.

Results: Frailty incidence in midlife trauma patients rose from 2.4% in 2012 to 5.1% in 2021. The adjusted annual incidence rate ratio (IRR) for midlife frailty was 1.08 (95% CI 1.08, 1.09). Among older adult patients, frailty incidence rose from 6.4% to 14.7%, with an adjusted annual frailty IRR of 1.10 (95% CI 1.10, 1.10).

Conclusion: Frailty is rising in both the midlife and older adult populations, indicating that these groups present increasing risk for unintentional falls and further morbidity and mortality. This underscores the necessity of fall screening in both midlife and older adult patients alongside further explorations into methods to delay the onset of frailty.

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日益严重的问题:美国中年成人创伤患者的虚弱。
背景:意外跌倒是成人患者受伤相关住院的最大原因。在中年和老年创伤患者中,虚弱是导致跌倒风险和不良预后的重要因素。尽管如此,在中年成年人中,虚弱的发生率仍未得到充分的研究,疾病预防控制中心的秋季筛查指南仅限于老年人。在这里,我们评估了美国中年和老年创伤患者的虚弱发生率。方法:采用创伤质量改善项目数据库对2012年至2021年中年(50-64岁)和老年人(65岁及以上)创伤患者进行回顾性研究。脆弱性采用五项修正脆弱性指数进行评估。通过泊松回归评估研究期间虚弱发生率的调整变化。结果:中年创伤患者的衰弱发生率从2012年的2.4%上升到2021年的5.1%。中年衰弱的调整年发病率比(IRR)为1.08 (95% CI 1.08, 1.09)。在老年患者中,衰弱发生率从6.4%上升到14.7%,调整后的年度衰弱IRR为1.10 (95% CI 1.10, 1.10)。结论:在中年和老年人群中,虚弱正在上升,表明这些人群出现意外跌倒和进一步发病率和死亡率的风险增加。这强调了在中年和老年患者中进行秋季筛查的必要性,同时进一步探索延缓虚弱发作的方法。
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来源期刊
Injury Prevention
Injury Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.30
自引率
2.70%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.
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