Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma
OBJECTIVE: To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.METHODS: We performed a chart review of 160 trauma patients age 65 and older with significant blunt thoracic trauma,...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2009-05-01
|
| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/9922n53h |
| _version_ | 1818530542237253632 |
|---|---|
| author | Lotfipour, Shahram Kaku, Shawn K Vaca, Federico E Patel, Chirag Anderson, Craig L Ahmed, Suleman S |
| author_facet | Lotfipour, Shahram Kaku, Shawn K Vaca, Federico E Patel, Chirag Anderson, Craig L Ahmed, Suleman S |
| author_sort | Lotfipour, Shahram |
| collection | DOAJ |
| description | OBJECTIVE: To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.METHODS: We performed a chart review of 160 trauma patients age 65 and older with significant blunt thoracic trauma, drawn from an American College of Surgeons Level I Trauma Center registry. Patients with serious injury to other body areas were excluded to prevent confounding the cause of adverse events. Adverse events were defined as acute respiratory distress syndrome or pneumonia, unanticipated intubation, transfer to the intensive care unit for hypoxemia, or death. Data collected included history, physical examination, radiographic findings, length of hospital stay, and clinical outcomes.RESULTS: Ninety-nine patients had isolated chest injury, while 61 others had other organ systems injured and were excluded. Sixteen patients developed adverse events [16.2% 95% confidence interval (CI) 9.5-24.9%], including two deaths. Adverse events were experienced by 19.2%, 6.1%, and 28.6% of those patients 65-74, 75-84, and >/=85 years old, respectively. The mean length of stay was 14.6 days in patients with an adverse event and 5.8 days in patients without. Post hoc analysis revealed that all 16 patients with an adverse event had one or more of the following: age >/=85, initial systolic blood pressure <90 mmHg, hemothorax, pneumothorax, three or more unilateral rib fractures, or pulmonary contusion (sensitivity 100%, CI 79.4-100%; specificity 38.6%, CI 28.1-49.9%).CONCLUSION: Adverse events from isolated thoracic trauma in elderly patients complicate 16% of our sample. These criteria were 100% sensitive and 38.5% specific for these adverse events. This study is a first step to identifying variables that might aid in identifying patients at high risk for serious adverse events. |
| first_indexed | 2024-12-11T17:21:00Z |
| format | Article |
| id | doaj.art-8d5ad3c6ae324a1ba22272b99ef1279b |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-11T17:21:00Z |
| publishDate | 2009-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-8d5ad3c6ae324a1ba22272b99ef1279b2022-12-22T00:57:09ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182009-05-011027984Factors Associated with Complications in Older Adults with Isolated Blunt Chest TraumaLotfipour, ShahramKaku, Shawn KVaca, Federico EPatel, ChiragAnderson, Craig LAhmed, Suleman SOBJECTIVE: To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.METHODS: We performed a chart review of 160 trauma patients age 65 and older with significant blunt thoracic trauma, drawn from an American College of Surgeons Level I Trauma Center registry. Patients with serious injury to other body areas were excluded to prevent confounding the cause of adverse events. Adverse events were defined as acute respiratory distress syndrome or pneumonia, unanticipated intubation, transfer to the intensive care unit for hypoxemia, or death. Data collected included history, physical examination, radiographic findings, length of hospital stay, and clinical outcomes.RESULTS: Ninety-nine patients had isolated chest injury, while 61 others had other organ systems injured and were excluded. Sixteen patients developed adverse events [16.2% 95% confidence interval (CI) 9.5-24.9%], including two deaths. Adverse events were experienced by 19.2%, 6.1%, and 28.6% of those patients 65-74, 75-84, and >/=85 years old, respectively. The mean length of stay was 14.6 days in patients with an adverse event and 5.8 days in patients without. Post hoc analysis revealed that all 16 patients with an adverse event had one or more of the following: age >/=85, initial systolic blood pressure <90 mmHg, hemothorax, pneumothorax, three or more unilateral rib fractures, or pulmonary contusion (sensitivity 100%, CI 79.4-100%; specificity 38.6%, CI 28.1-49.9%).CONCLUSION: Adverse events from isolated thoracic trauma in elderly patients complicate 16% of our sample. These criteria were 100% sensitive and 38.5% specific for these adverse events. This study is a first step to identifying variables that might aid in identifying patients at high risk for serious adverse events.http://escholarship.org/uc/item/9922n53hTraumabluntelderlythoracicpredictor variables |
| spellingShingle | Lotfipour, Shahram Kaku, Shawn K Vaca, Federico E Patel, Chirag Anderson, Craig L Ahmed, Suleman S Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma Western Journal of Emergency Medicine Trauma blunt elderly thoracic predictor variables |
| title | Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma |
| title_full | Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma |
| title_fullStr | Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma |
| title_full_unstemmed | Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma |
| title_short | Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma |
| title_sort | factors associated with complications in older adults with isolated blunt chest trauma |
| topic | Trauma blunt elderly thoracic predictor variables |
| url | http://escholarship.org/uc/item/9922n53h |
| work_keys_str_mv | AT lotfipourshahram factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma AT kakushawnk factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma AT vacafedericoe factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma AT patelchirag factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma AT andersoncraigl factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma AT ahmedsulemans factorsassociatedwithcomplicationsinolderadultswithisolatedbluntchesttrauma |