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The revised cardiac...
The revised cardiac risk index is associated with morbidity and mortality independent of injury severity in elderly patients with rib fractures
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- Bass, Gary Alan, 1979- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Leonard Davis Institute of Health Economics (LDI), University of Pennsylvania, Philadelphia, USA; Center for Peri-Operative Outcomes Research and Transformation (CPORT), University of Pennsylvania, Philadelphia, USA
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- Duffy, Caoimhe C. (författare)
- Leonard Davis Institute of Health Economics (LDI), University of Pennsylvania, Philadelphia, USA; Center for Peri-Operative Outcomes Research and Transformation (CPORT), University of Pennsylvania, Philadelphia, USA
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- Kaplan, Lewis J. (författare)
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Department of Anesthesia and Critical Care, University of Pennsylvania, Philadelphia, USA; Corporal Michael Cresenscz Veterans Affairs Medical Center (CMCVAMC), Philadelphia, USA
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- Sarani, Babak (författare)
- Center for Trauma and Critical Care, George Washington University School of Medicine & Health Sciences, Washington D.C., USA
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- Martin, Niels D. (författare)
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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- Mohammad Ismail, Ahmad, 1993- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län
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- Cao, Yang, Associate Professor, 1972- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Forssten, Maximilian Peter, 1996- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper
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- Mohseni, Shahin, 1978- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma & Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 54:1, s. 56-62
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Risk factors for mortality and in-hospital morbidity among geriatric patients with traumatic rib fractures remain unclear. Such patients are often frail and demonstrate a high comorbidity burden. Moreover, outcomes anticipated by current rubrics may reflect the influence of multisystem injury or surgery, and thus not apply to isolated injuries in geriatric patients. We hypothesized that the Revised Cardiac Risk Index (RCRI) may assist in risk-stratifying geriatric patients following rib fracture.METHODS: All geriatric patients (age ≥65 years) with a conservatively managed rib fracture owing to an isolated thoracic injury (thorax AIS ≥1), in the 2013-2019 TQIP database were assessed including demographics and outcomes. The association between the RCRI and in-hospital morbidity as well as mortality was analyzed using Poisson regression models while adjusting for potential confounders.RESULTS: 96,750 geriatric patients sustained rib fractures. Compared to those with RCRI 0, patients with an RCRI score of 1 had a 16% increased risk of in-hospital mortality [adjusted incidence rate ratio (adj-IRR), 95% confidence interval (CI): 1.16 (1.02-1.32), p=0.020]. An RCRI score of 2 [adj-IRR (95% CI): 1.72 (1.44-2.06), p<0.001] or ≥3 [adj-IRR (95% CI): 3.07 (2.31-4.09), p<0.001] was associated with an even greater mortality risk. Those with an increased RCRI also exhibited a higher incidence of myocardial infarction, cardiac arrest, stroke, and acute respiratory distress syndrome.CONCLUSIONS: Geriatric patients with rib fractures and an RCRI ≥1 represent a vulnerable and high-risk group. This index may inform the decision to admit for inpatient care and can also guide patient and family counseling as well as computer-based decision-support.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
Nyckelord
- Geriatric
- Revised cardiac risk index
- Rib fracture
- Risk stratification
- Thoracic trauma
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Injury
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Bass, Gary Alan, ...
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Duffy, Caoimhe C ...
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Kaplan, Lewis J.
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Sarani, Babak
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Martin, Niels D.
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Mohammad Ismail, ...
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Cao, Yang, Assoc ...
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Forssten, Maximi ...
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Mohseni, Shahin, ...
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