Characteristics of Elderly Long-Term Care Residents Who Were Injured and Transferred to Hospital Emergency Departments in Korea: A Retrospective Multicenter Study

Namgung, Myeong; Kim, Keon Ho; Lee, Dong Hoon; Yune, Ho Young; Wee, Jung Hee; Kim, Duk Ho; Kim, Eui Chung; Lim, Jee Yong

doi:10.1155/2019/7803184

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Characteristics of Elderly Long-Term Care Residents Who Were Injured and Transferred to Hospital Emergency Departments in Korea: A Retrospective Multicenter Study

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Author(s): Myeong Namgung ¹ , Keon Kim ² ^, , Dong Hoon Lee ³ , Ho Young Yune ⁴ , Jung Hee Wee ⁵ , Duk Ho Kim ⁶ , Eui Chung Kim ⁷ , Jee Yong Lim ⁸

Publication date (Electronic): 2 June 2019

Journal: Emergency Medicine International

Publisher: Hindawi

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Abstract

The objective of this retrospective multicenter study was to investigate the mechanism and characteristics of trauma experienced by patients aged ≥65 years who were transferred from a long-term care hospital to one of five university hospital emergency departments. Of 255,543 patients seen in one of the five emergency departments, 79 were transferred from a long-term care hospital because of trauma. The most common trauma mechanism was slipping down, with 33 (58.9%) patients, followed by falling from a bed (17.9%), striking an object such as a wall or corner (10.7%), overextending a joint (8.9%), and unknown mechanisms (3.6%). Many cases of slip (39.4%) occurred in relation to the bathroom. Comparing slip and fall from a bed, we found more hip fractures (95.2%) because of slipping down than falling from a bed (57.1%); traumatic brain injury only occurred in slip cases. These traumas cause significant morbidity in elderly patients; therefore, we sought to identify strategies that prevent slip in long-term care hospitals.

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Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Jorma Panula, Harri Pihlajamäki, Ville Mattila … (2011)

Background The high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population. Methods Records of 428 consecutive hip fracture patients were collected on a population-basis and data on the general population comprising all Finns 65 years of age or older were collected on a cohort-basis. Cause of death was classified as follows: malignant neoplasms, dementia, circulatory disease, respiratory disease, digestive system disease, and other. Results Mean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the follow-up, age-adjusted mortality after hip fracture surgery was higher in men than in women with hazard ratio (HR) 1.55 and 95% confidence interval (95% CI) 1.21-2.00. Among hip surgery patients, the most common causes of death were circulatory diseases, followed by dementia and Alzheimer's disease. After hip fracture, men were more likely than women to die from respiratory disease, malignant neoplasm, and circulatory disease. During the follow-up, all-cause age- and sex-standardized mortality after hip fracture was 3-fold higher than that of the general population and included every cause-of-death category. Conclusion During the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.

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Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project.

M Katsoulis, V Benetou, T Karapetyan … (2017)

Hip fractures are associated with diminished quality of life and survival especially amongst the elderly.

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Isolated traumatic brain injury: age is an independent predictor of mortality and early outcome.

Anne Mosenthal, R. Lavery, Edwin A. Deitch … (2002)

Geriatric trauma patients have a worse outcome than the young with comparable injuries. The contribution of traumatic brain injury (TBI) to this increased mortality is unknown and has been confounded by the presence of other injuries. The purpose of this study was to investigate the role of age in the mortality and early outcome from isolated TBI. This was a retrospective analysis of all adult patients with isolated TBI (Abbreviated Injury Scale score > or = 3) admitted during a 5-year period to two Level I trauma centers. Mortality, Glasgow Outcome Scale score at discharge, therapy, and complications were compared for elderly (age > or = 65 years) and younger patients. Of 694 patients, 22% were defined as elderly. The mortality for the elderly group was twice that of their younger counterparts (30% vs. 14%, p < 0.001), even for those with mild to moderate TBI (Glasgow Coma Scale score of 9-15). Thirteen percent of elderly survivors had a poor functional outcome (Glasgow Outcome Scale score of 2 or 3) at hospital discharge versus 5% in the young group (p < 0.01). Independent factors associated with a high mortality were age and Glasgow Coma Scale score. The mortality from TBI is higher in the geriatric population at all levels of head injury. In addition, functional outcome at hospital discharge is worse. Although some of this increased mortality may be explained by complications or type of head injury, age itself is an independent predictor for mortality in TBI.

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Author and article information

Contributors

Keon Kim:

ORCID: http://orcid.org/0000-0002-5174-833X

Journal

Journal ID (nlm-ta): Emerg Med Int

Journal ID (iso-abbrev): Emerg Med Int

Journal ID (publisher-id): EMI

Title: Emergency Medicine International

Publisher: Hindawi

ISSN (Print): 2090-2840

ISSN (Electronic): 2090-2859

Publication date Collection: 2019

Publication date (Electronic): 2 June 2019

Volume: 2019

Electronic Location Identifier: 7803184

Affiliations

¹Department of Emergency Medicine, Chung-Ang University Hospital, Seoul 06973, Republic of Korea

²Department of Emergency Medicine, Ewha Womans University Hospital, Seoul 07985, Republic of Korea

³Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06973, Republic of Korea

⁴Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do 18450, Republic of Korea

⁵Department of Emergency Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea

⁶Department of Emergency Medicine, Eulji University, Seoul 01830, Republic of Korea

⁷Department of Emergency Medicine, CHA University School of Medicine, Seongnam-si 13496, Republic of Korea

⁸Department of Emergency Medicine, Seoul St. Mary's Hospital, Seoul 065691, Republic of Korea

Author notes

Academic Editor: Robert Derlet

Author information

Myeong Namgung http://orcid.org/0000-0002-3235-4749

Keon Kim http://orcid.org/0000-0002-5174-833X

Dong Hoon Lee http://orcid.org/0000-0003-4306-8649

Jung Hee Wee http://orcid.org/0000-0001-6240-5458

Eui Chung Kim http://orcid.org/0000-0003-3113-2033

Article

DOI: 10.1155/2019/7803184

PMC ID: 6582857

SO-VID: 7aa667c9-34b2-4bba-8fb3-ed98d8317487

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 3 December 2018

Date accepted : 19 May 2019

Funding

Funded by: Chung-Ang University

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