Juan Antonio Llompart-Pou1, Mario Chico-Fernández2, Marcelino Sánchez-Casado3, Fermín Alberdi-Odriozola4, Francisco Guerrero-López5, María Dolores Mayor-García6, Javier González-Robledo7, María Ángeles Ballesteros-Sanz8, Rubén Herrán-Monge9, Rafael León-López10, Lucía López-Amor11, Ana Bueno-González12. 1. Servei de Medicina Intensiva. Hospital Universitari Son Espases, Palma de Mallorca, Spain. 2. UCI de Trauma y Emergencias. Servicio de Medicina Intensiva. Hospital Universitario 12 de Octubre, Madrid, Spain. Electronic address: murgchico@yahoo.es. 3. Servicio de Medicina Intensiva. Hospital Virgen de la Salud, Toledo, Spain. 4. Servicio de Medicina Intensiva. Hospital Universitario de Donostia, San Sebastián, Spain. 5. Servicio de Medicina Intensiva. Hospital Universitario Virgen de las Nieves, Granada, Spain. 6. Servicio de Medicina Intensiva. Complejo Hospitalario de Torrecárdenas, Almería, Spain. 7. Servicio de Medicina Intensiva. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain. 8. Servicio de Medicina Intensiva. Hospital Universitario Marqués de Valdecilla, Santander, Spain. 9. Servicio de Medicina Intensiva. Hospital Universitario Río Hortega, Valladolid, Spain. 10. Servicio de Medicina Intensiva. Ciudad Sanitaria Reina Sofía, Córdoba, Spain. 11. Servicio de Medicina Intensiva. Hospital Universitario Central De Asturias, Asturias, Spain. 12. Servicio de Medicina Intensiva. Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Abstract
BACKGROUND: Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23rd, 2012 to July 31st, 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly). Quantitative data were reported as median (Interquartile Range (IQR) 25-75) and categorical data as number and percentage. Comparison between groups of age with quantitative variables was performed using the analysis of variance (ANOVA) test. Differences between groups with categorical variables were compared using the chi-square test. A value of p<0.05 was considered significant. RESULTS: We included 2700 patients (78.9% male). Median age was 46 (31-62) years. Blunt trauma was present in 93.7% of the patients. Median RTS was 7.55 (5.97-7.84). Median ISS was 20 (13-26). High-energy trauma secondary to motor-vehicle accident with rhabdomyolysis and drugs abuse showed an inverse linear association with ageing, whilst pedestrian falls with isolated brain injury, being run-over and pre-injury antiplatelets or anticoagulant treatment increased with age (in all cases p<0.001). Multiple injuries were more common in young adults (p<0.001). Acute kidney injury prevalence was higher in elderly and very elderly patients (p<0.001). ICU Mortality increased with age in spite of similar severity scores in all groups (p<0.001). The main cause of death in all groups was intracranial hypertension. CONCLUSIONS: Different injury patterns exist in relation with ageing in trauma ICU patients. Adult patients were more likely to present high-energy trauma with significant injuries in different areas whilst elderly patients were prone to low-energy falls, complicated by antiplatelets or anticoagulants use, resulting in severe brain injury and increased mortality.
BACKGROUND: Injury patterns may differ in traumapatients when age is considered. This information is relevant in the management of traumapatients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23rd, 2012 to July 31st, 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly). Quantitative data were reported as median (Interquartile Range (IQR) 25-75) and categorical data as number and percentage. Comparison between groups of age with quantitative variables was performed using the analysis of variance (ANOVA) test. Differences between groups with categorical variables were compared using the chi-square test. A value of p<0.05 was considered significant. RESULTS: We included 2700 patients (78.9% male). Median age was 46 (31-62) years. Blunt trauma was present in 93.7% of the patients. Median RTS was 7.55 (5.97-7.84). Median ISS was 20 (13-26). High-energy trauma secondary to motor-vehicle accident with rhabdomyolysis and drugs abuse showed an inverse linear association with ageing, whilst pedestrian falls with isolated brain injury, being run-over and pre-injury antiplatelets or anticoagulant treatment increased with age (in all cases p<0.001). Multiple injuries were more common in young adults (p<0.001). Acute kidney injury prevalence was higher in elderly and very elderly patients (p<0.001). ICU Mortality increased with age in spite of similar severity scores in all groups (p<0.001). The main cause of death in all groups was intracranial hypertension. CONCLUSIONS: Different injury patterns exist in relation with ageing in trauma ICUpatients. Adult patients were more likely to present high-energy trauma with significant injuries in different areas whilst elderly patients were prone to low-energy falls, complicated by antiplatelets or anticoagulants use, resulting in severe brain injury and increased mortality.
Authors: Juan Antonio Llompart-Pou; Jon Pérez-Bárcena; Mario Chico-Fernández; Marcelino Sánchez-Casado; Joan Maria Raurich Journal: World J Crit Care Med Date: 2017-05-04
Authors: Luis Serviá; Neus Montserrat; Mariona Badia; Juan Antonio Llompart-Pou; Jesús Abelardo Barea-Mendoza; Mario Chico-Fernández; Marcelino Sánchez-Casado; José Manuel Jiménez; Dolores María Mayor; Javier Trujillano Journal: BMC Med Res Methodol Date: 2020-10-20 Impact factor: 4.615
Authors: Luis Serviá; Juan Antonio Llompart-Pou; Mario Chico-Fernández; Neus Montserrat; Mariona Badia; Jesús Abelardo Barea-Mendoza; María Ángeles Ballesteros-Sanz; Javier Trujillano Journal: Crit Care Date: 2021-12-07 Impact factor: 9.097