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중증의 노인외상환자에서의 사망예측요소
Severe Geriatric Trauma : Predictive Factor of Mortality
이서영(Seo Young Lee),이진웅(Jin Woong Lee),문중범(Joong Bum Moon),안희철(Hee Chul Ahn),이강현(Kang Hyun Lee),황성오(Sung Oh Hwang)
UCI I410-ECN-0102-2009-510-004776666

Background: Despite the increase in the elderly population, little research has been done regarding the factors that predict mortality in older patients. The purpose of this study was to isolate factors that might predict mortality. Method: The charts of 92 patients older than 65 years who were admitted to the Emergency Department of Wonju Christian Hospital after trauma were reviewed. Variables studied included age, sex, systolic blood pressure and pulse rate at admission, mechanism of injury, injury severity score (ISS), revised trauma score (RTS), Glasgow coma scale (GCS), pH, base excess, hemoglobin, amount of blood transfusion, pre-existing illness, and complications. A chi-squared test, a t-test, and a logistic regression were done as appropriate for the type of variable. Results: Thirty-one patients died; 61 patients survived. The mean age at the time of injury was 72±6 years (range, 65-88 years). The mean ISS was 23.6±11.1. Statistical significance (p<0.05) was reached for the following factors for the patients who died: higher ISS, lower GCS, lower RTS, lower systolic blood pressure (BP), lower respiration rate (RR), lower pH, higher base deficit (BD), higher packed RBC requirement, and a higher abdominal AIS (abbreviated injury score). Logistic regression showed that ISS (odds ratio=0.017; p<0.048), GCS (odds ratio=0.76; p<0.001), and packed RBC requirement (odds ratio=1.346; p<0.013) were independent predictors of mortality. Conclusion: Poor survival was predicted by the ISS, the GCS, and the packed RBC requirement. Further efforts are needed to evaluate the risk of mortality for elderly trauma patients.

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