摘要
目的 评价老年人严重多发伤致伤原因的构成及病死率。 方法 回顾性分析 1995年 1月至 2 0 0 0年 1月 5年间收治的老年严重多发伤患者 80例 (老年组 ) ,与同期收治的青中年组(18～ 35岁 ) 4 2 2例进行对照分析 ,用简明损伤定级 (AIS90 )和损伤严重程度评分 (ISS)标准进行评估 ,所有患者ISS≥ 16。 结果 青中年组和老年组的主要致伤原因都是交通事故 ,青中年组的病死率明显低于老年组 (分别为 14 2 %和 37 5 % ,P <0 0 5 ) ,老年组中ISS≥ 5 0的患者均死亡。两组的主要死亡原因是严重的头部损伤 (71 8%和 73 3% ) ,老年组死于多器官功能衰竭综合征 (MODS)和脓毒血症的病死率为 6 3 % ,青中年组为 0。老年组伤前并存症、伤后或术后并发症的发生率、ICU治疗时间、住院时间明显高于青中年组。 结论 对于老年严重多发伤患者积极采取有效的救治措施是减少并发症、降低病死率。
Objective To evaluate the mortality and causes of injury among elderly patients with multiple injuries. Methods All the young (18 to 35 years, n=422) and elderly (60 87years, n=80) patients were evaluated with an abbreviated injury scale score (AIS) injury severity score (ISS).All patients with ISS ≥16 were selected in period 5 year (from January 1995 to January 2000) . Age, sex, mechanisms of injury, mortality, hospitalization, and intensive care treatment were analyzed. Results Traffic accident was the leading cause of injury in both young and elderly groups. Mortality in the young was lower than that in the elderly (14 2% vs 37 5%, P <0 05); all the elderly with an injury severity score≥50 died. Most of the deaths in the young and the elderly were caused by severe brain injury (71 7% vs 73 3%). Fatality due to multiple organ dysfunctional syndrome (MODS) and sepsis in the elderly was 6 3% and the fatality due to above montioned causes was not obsorved in the young group. Those causes but deaths related to were not observed in the young. The situations of reexisting diseases, the high incidence of complications after injuries and operations, the long duration of intensive care treatment and hospitalization in the elderly much more common than that in the young. Conclusions An early and comprehensive care is the key to decrease the mortality and hospitalizations as well as to prevent complications of severely multiple injuries in the elderly.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2001年第4期272-274,共3页
Chinese Journal of Geriatrics
