{"title":"识别老年人的风险评分，以确定创伤髋部骨折患者的老年评估。","authors":"Taylor K Long, Stephanie D Booza, Lauren N Turner","doi":"10.1097/JTN.0000000000000719","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Trauma centers are confronted with rising numbers of geriatric trauma patients at high risk for adverse outcomes. Geriatric screening is advocated but not standardized within trauma centers.</p><p><strong>Objective: </strong>This study aims to describe the impact of Identification of Seniors at Risk (ISAR) screening on patient outcomes and geriatric evaluations.</p><p><strong>Methods: </strong>This study used a pre-/postdesign to assess the impact of ISAR screening on patient outcomes and geriatric evaluations in trauma patients 60 years and older, comparing the periods before (2014-2016) and after (2017-2019) screening implementation.</p><p><strong>Results: </strong>Charts for 1,142 patients were reviewed. Comparing pre- to post-ISAR groups, the post-ISAR group with geriatric evaluations were older (M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69; p = .026) with higher Injury Severity Scores (M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92; p = .001). There was no significant difference in length of stay, intensive care unit length of stay, readmission rate, hospice consults, or inhospital mortality. Inhospital mortality (n = 8/380, 2.11% vs. n = 4/434, 0.92%) and length of stay in hours (M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06) down-trended in the postgroup with geriatric evaluation.</p><p><strong>Conclusion: </strong>Resources and care coordination efforts can be directed toward specific geriatric screening scores to achieve optimal outcomes. Varying results were found related to outcomes of geriatric evaluations prompting future research.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"142-149"},"PeriodicalIF":0.7000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Identification of Seniors at Risk Score to Determine Geriatric Evaluations on Trauma Patients With Hip Fractures.\",\"authors\":\"Taylor K Long, Stephanie D Booza, Lauren N Turner\",\"doi\":\"10.1097/JTN.0000000000000719\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Trauma centers are confronted with rising numbers of geriatric trauma patients at high risk for adverse outcomes. Geriatric screening is advocated but not standardized within trauma centers.</p><p><strong>Objective: </strong>This study aims to describe the impact of Identification of Seniors at Risk (ISAR) screening on patient outcomes and geriatric evaluations.</p><p><strong>Methods: </strong>This study used a pre-/postdesign to assess the impact of ISAR screening on patient outcomes and geriatric evaluations in trauma patients 60 years and older, comparing the periods before (2014-2016) and after (2017-2019) screening implementation.</p><p><strong>Results: </strong>Charts for 1,142 patients were reviewed. Comparing pre- to post-ISAR groups, the post-ISAR group with geriatric evaluations were older (M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69; p = .026) with higher Injury Severity Scores (M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92; p = .001). There was no significant difference in length of stay, intensive care unit length of stay, readmission rate, hospice consults, or inhospital mortality. Inhospital mortality (n = 8/380, 2.11% vs. n = 4/434, 0.92%) and length of stay in hours (M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06) down-trended in the postgroup with geriatric evaluation.</p><p><strong>Conclusion: </strong>Resources and care coordination efforts can be directed toward specific geriatric screening scores to achieve optimal outcomes. Varying results were found related to outcomes of geriatric evaluations prompting future research.</p>\",\"PeriodicalId\":51329,\"journal\":{\"name\":\"Journal of Trauma Nursing\",\"volume\":\"30 3\",\"pages\":\"142-149\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Trauma Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JTN.0000000000000719\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Trauma Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JTN.0000000000000719","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:创伤中心面临着越来越多的老年创伤患者在高风险的不良后果。老年筛查被提倡，但在创伤中心没有标准化。目的:本研究旨在描述老年危险识别(ISAR)筛查对患者预后和老年评估的影响。方法:本研究采用前后设计评估ISAR筛查对60岁及以上创伤患者预后和老年评估的影响，比较筛查实施前(2014-2016年)和实施后(2017-2019年)的影响。结果:回顾了1142例患者的图表。与isar治疗前后比较，isar治疗后进行老年评估的患者年龄更大(M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69;p = 0.026)，损伤严重程度评分较高(M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92;P = .001)。在住院时间、重症监护病房住院时间、再入院率、临终关怀咨询或住院死亡率方面没有显著差异。住院死亡率(n = 8/380, 2.11% vs. n = 4/434, 0.92%)和住院时间(M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06)在老年评估组后呈下降趋势。结论:资源和护理协调工作可以针对特定的老年筛查得分，以达到最佳效果。不同的结果被发现与老年评估的结果有关，这促使了未来的研究。
Identification of Seniors at Risk Score to Determine Geriatric Evaluations on Trauma Patients With Hip Fractures.
Background: Trauma centers are confronted with rising numbers of geriatric trauma patients at high risk for adverse outcomes. Geriatric screening is advocated but not standardized within trauma centers.
Objective: This study aims to describe the impact of Identification of Seniors at Risk (ISAR) screening on patient outcomes and geriatric evaluations.
Methods: This study used a pre-/postdesign to assess the impact of ISAR screening on patient outcomes and geriatric evaluations in trauma patients 60 years and older, comparing the periods before (2014-2016) and after (2017-2019) screening implementation.
Results: Charts for 1,142 patients were reviewed. Comparing pre- to post-ISAR groups, the post-ISAR group with geriatric evaluations were older (M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69; p = .026) with higher Injury Severity Scores (M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92; p = .001). There was no significant difference in length of stay, intensive care unit length of stay, readmission rate, hospice consults, or inhospital mortality. Inhospital mortality (n = 8/380, 2.11% vs. n = 4/434, 0.92%) and length of stay in hours (M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06) down-trended in the postgroup with geriatric evaluation.
Conclusion: Resources and care coordination efforts can be directed toward specific geriatric screening scores to achieve optimal outcomes. Varying results were found related to outcomes of geriatric evaluations prompting future research.
期刊介绍：
Journal of Trauma Nursing (JTN) is the official journal of the Society of Trauma Nurses.
The Society of Trauma Nurses believes that trauma is a disease impacting patients through the continuum of care. The mission of STN is to ensure optimal trauma care through education, collaboration, leadership and membership engagement. As the official publication of the Society of Trauma Nurses, the Journal of Trauma Nursing supports the STN’s strategic goals of effective communication, education and patient advocacy with original, peer-reviewed, research and evidence-based articles and information that reflect the highest standard of collaborative care for trauma patients.
The Journal of Trauma Nursing, through a commitment to editorial excellence, implements STN’s vision to improve practice and patient outcomes and to become the premiere global nursing organization across the trauma continuum.
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