Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review: a retrospective cohort review
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| Titel: | Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review: a retrospective cohort review |
|---|---|
| Autoren: | Antonia C Hoyle, Leela C Biant, Mike Young |
| Quelle: | Hoyle, A C, Biant, L C & Young, M 2020, 'Undertriage of the elderly major trauma patient continues in major trauma centre care : a retrospective cohort review', Emergency medicine journal : EMJ, vol. 37, no. 8, pp. 508-514. https://doi.org/10.1136/emermed-2019-208541 |
| Verlagsinformationen: | BMJ, 2020. |
| Publikationsjahr: | 2020 |
| Schlagwörter: | Male, United Kingdom/epidemiology, United Kingdom, 3. Good health, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Trauma Centers, Triage/standards, Humans, Wounds and Injuries, Wounds and Injuries/classification, Female, Triage, Aged, Retrospective Studies |
| Beschreibung: | BackgroundMajor trauma (Injury Severity Score (ISS) ≥16) in older people is increasing, but concerns persist that major trauma is not always recognised in older patients on triage. This study compared undertriage of older and younger adult major trauma patients in the major trauma centre (MTC) setting to investigate this concern.MethodsA retrospective review of Trauma Audit and Research Network data was conducted for three MTCs in the UK for 3 months in 2014. Age, ISS, injury mechanism and injured areas were examined for all severely injured patients (ISS ≥16) and appropriate major trauma triage rates measured via the surrogate markers of trauma team activation and the presence of a consultant first attender, as per standards for major trauma care set by National Confidential Enquiry into Patient Outcomes and Deaths, Royal College of Surgeons of England and the British Orthopaedic Association. Trends in older (age ≥65) and younger (ages 18–64) adult major trauma presentation, triage and reception were reviewed.ResultsOf 153 severely injured patients, 46 were aged ≥65. Older patients were significantly less likely to receive the attention of a consultant first attender or trauma team. Similar trends were also seen on subgroup analysis by mechanism of injury or number of injured body areas. Older major trauma patients exhibit a higher mortality, despite a lower median ISS (older patient ISS=20 (IQR 16–25), younger patient ISS=25 (IQR 18–29)).ConclusionOlder major trauma patients are at greater risk of undertriage, even in the MTC environment. Existing hospital trauma triage practices should be further investigated to explain and reduce undertriage of elderly trauma patients. |
| Publikationsart: | Article |
| Sprache: | English |
| ISSN: | 1472-0213 1472-0205 |
| DOI: | 10.1136/emermed-2019-208541 |
| Zugangs-URL: | https://pubmed.ncbi.nlm.nih.gov/32546474 https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc https://doi.org/10.1136/emermed-2019-208541 https://www.research.manchester.ac.uk/portal/en/publications/undertriage-of-the-elderly-major-trauma-patient-continues-in-major-trauma-centre-care(d5e374b0-2624-4be6-87a6-61dfb86303bc).html https://www.ncbi.nlm.nih.gov/pubmed/32546474 https://emj.bmj.com/content/emermed/37/8/508.full.pdf https://emj.bmj.com/content/early/2020/06/16/emermed-2019-208541 https://pubmed.ncbi.nlm.nih.gov/32546474/ https://emj.bmj.com/content/37/8/508 https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc https://doi.org/10.1136/emermed-2019-208541 http://europepmc.org/abstract/med/32546474 |
| Dokumentencode: | edsair.doi.dedup.....e32ee49349c4debd7b16c93fe607e67d |
| Datenbank: | OpenAIRE |
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| Items | – Name: Title Label: Title Group: Ti Data: Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review: a retrospective cohort review – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Antonia+C+Hoyle%22">Antonia C Hoyle</searchLink><br /><searchLink fieldCode="AR" term="%22Leela+C+Biant%22">Leela C Biant</searchLink><br /><searchLink fieldCode="AR" term="%22Mike+Young%22">Mike Young</searchLink> – Name: TitleSource Label: Source Group: Src Data: Hoyle, A C, Biant, L C & Young, M 2020, 'Undertriage of the elderly major trauma patient continues in major trauma centre care : a retrospective cohort review', Emergency medicine journal : EMJ, vol. 37, no. 8, pp. 508-514. https://doi.org/10.1136/emermed-2019-208541 – Name: Publisher Label: Publisher Information Group: PubInfo Data: BMJ, 2020. – Name: DatePubCY Label: Publication Year Group: Date Data: 2020 – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22Male%22">Male</searchLink><br /><searchLink fieldCode="DE" term="%22United+Kingdom%2Fepidemiology%22">United Kingdom/epidemiology</searchLink><br /><searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink><br /><searchLink fieldCode="DE" term="%223%2E+Good+health%22">3. Good health</searchLink><br /><searchLink fieldCode="DE" term="%2203+medical+and+health+sciences%22">03 medical and health sciences</searchLink><br /><searchLink fieldCode="DE" term="%22Injury+Severity+Score%22">Injury Severity Score</searchLink><br /><searchLink fieldCode="DE" term="%220302+clinical+medicine%22">0302 clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Trauma+Centers%22">Trauma Centers</searchLink><br /><searchLink fieldCode="DE" term="%22Triage%2Fstandards%22">Triage/standards</searchLink><br /><searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22Wounds+and+Injuries%22">Wounds and Injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Wounds+and+Injuries%2Fclassification%22">Wounds and Injuries/classification</searchLink><br /><searchLink fieldCode="DE" term="%22Female%22">Female</searchLink><br /><searchLink fieldCode="DE" term="%22Triage%22">Triage</searchLink><br /><searchLink fieldCode="DE" term="%22Aged%22">Aged</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> – Name: Abstract Label: Description Group: Ab Data: BackgroundMajor trauma (Injury Severity Score (ISS) ≥16) in older people is increasing, but concerns persist that major trauma is not always recognised in older patients on triage. This study compared undertriage of older and younger adult major trauma patients in the major trauma centre (MTC) setting to investigate this concern.MethodsA retrospective review of Trauma Audit and Research Network data was conducted for three MTCs in the UK for 3 months in 2014. Age, ISS, injury mechanism and injured areas were examined for all severely injured patients (ISS ≥16) and appropriate major trauma triage rates measured via the surrogate markers of trauma team activation and the presence of a consultant first attender, as per standards for major trauma care set by National Confidential Enquiry into Patient Outcomes and Deaths, Royal College of Surgeons of England and the British Orthopaedic Association. Trends in older (age ≥65) and younger (ages 18–64) adult major trauma presentation, triage and reception were reviewed.ResultsOf 153 severely injured patients, 46 were aged ≥65. Older patients were significantly less likely to receive the attention of a consultant first attender or trauma team. Similar trends were also seen on subgroup analysis by mechanism of injury or number of injured body areas. Older major trauma patients exhibit a higher mortality, despite a lower median ISS (older patient ISS=20 (IQR 16–25), younger patient ISS=25 (IQR 18–29)).ConclusionOlder major trauma patients are at greater risk of undertriage, even in the MTC environment. Existing hospital trauma triage practices should be further investigated to explain and reduce undertriage of elderly trauma patients. – Name: TypeDocument Label: Document Type Group: TypDoc Data: Article – Name: Language Label: Language Group: Lang Data: English – Name: ISSN Label: ISSN Group: ISSN Data: 1472-0213<br />1472-0205 – Name: DOI Label: DOI Group: ID Data: 10.1136/emermed-2019-208541 – Name: URL Label: Access URL Group: URL Data: <link linkTarget="URL" linkTerm="https://pubmed.ncbi.nlm.nih.gov/32546474" linkWindow="_blank">https://pubmed.ncbi.nlm.nih.gov/32546474</link><br /><link linkTarget="URL" linkTerm="https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc" linkWindow="_blank">https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc</link><br /><link linkTarget="URL" linkTerm="https://doi.org/10.1136/emermed-2019-208541" linkWindow="_blank">https://doi.org/10.1136/emermed-2019-208541</link><br /><link linkTarget="URL" linkTerm="https://www.research.manchester.ac.uk/portal/en/publications/undertriage-of-the-elderly-major-trauma-patient-continues-in-major-trauma-centre-care(d5e374b0-2624-4be6-87a6-61dfb86303bc).html" linkWindow="_blank">https://www.research.manchester.ac.uk/portal/en/publications/undertriage-of-the-elderly-major-trauma-patient-continues-in-major-trauma-centre-care(d5e374b0-2624-4be6-87a6-61dfb86303bc).html</link><br /><link linkTarget="URL" linkTerm="https://www.ncbi.nlm.nih.gov/pubmed/32546474" linkWindow="_blank">https://www.ncbi.nlm.nih.gov/pubmed/32546474</link><br /><link linkTarget="URL" linkTerm="https://emj.bmj.com/content/emermed/37/8/508.full.pdf" linkWindow="_blank">https://emj.bmj.com/content/emermed/37/8/508.full.pdf</link><br /><link linkTarget="URL" linkTerm="https://emj.bmj.com/content/early/2020/06/16/emermed-2019-208541" linkWindow="_blank">https://emj.bmj.com/content/early/2020/06/16/emermed-2019-208541</link><br /><link linkTarget="URL" linkTerm="https://pubmed.ncbi.nlm.nih.gov/32546474/" linkWindow="_blank">https://pubmed.ncbi.nlm.nih.gov/32546474/</link><br /><link linkTarget="URL" linkTerm="https://emj.bmj.com/content/37/8/508" linkWindow="_blank">https://emj.bmj.com/content/37/8/508</link><br /><link linkTarget="URL" linkTerm="https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc" linkWindow="_blank">https://research.manchester.ac.uk/en/publications/d5e374b0-2624-4be6-87a6-61dfb86303bc</link><br /><link linkTarget="URL" linkTerm="https://doi.org/10.1136/emermed-2019-208541" linkWindow="_blank">https://doi.org/10.1136/emermed-2019-208541</link><br /><link linkTarget="URL" linkTerm="http://europepmc.org/abstract/med/32546474" linkWindow="_blank">http://europepmc.org/abstract/med/32546474</link> – Name: AN Label: Accession Number Group: ID Data: edsair.doi.dedup.....e32ee49349c4debd7b16c93fe607e67d |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1136/emermed-2019-208541 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 508 Subjects: – SubjectFull: Male Type: general – SubjectFull: United Kingdom/epidemiology Type: general – SubjectFull: United Kingdom Type: general – SubjectFull: 3. Good health Type: general – SubjectFull: 03 medical and health sciences Type: general – SubjectFull: Injury Severity Score Type: general – SubjectFull: 0302 clinical medicine Type: general – SubjectFull: Trauma Centers Type: general – SubjectFull: Triage/standards Type: general – SubjectFull: Humans Type: general – SubjectFull: Wounds and Injuries Type: general – SubjectFull: Wounds and Injuries/classification Type: general – SubjectFull: Female Type: general – SubjectFull: Triage Type: general – SubjectFull: Aged Type: general – SubjectFull: Retrospective Studies Type: general Titles: – TitleFull: Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review: a retrospective cohort review Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Antonia C Hoyle – PersonEntity: Name: NameFull: Leela C Biant – PersonEntity: Name: NameFull: Mike Young IsPartOfRelationships: – BibEntity: Dates: – D: 16 M: 06 Type: published Y: 2020 Identifiers: – Type: issn-print Value: 14720213 – Type: issn-print Value: 14720205 – Type: issn-locals Value: edsair Numbering: – Type: volume Value: 37 Titles: – TitleFull: Emergency Medicine Journal Type: main |
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