Are Geriatric Patients Who Sustain High-Energy Traumatic Injury Likely to Return to Functional Independence?. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: Shah, Jason; Titus, Alexander J.; O'Toole, Robert V.; Sciadini, Marcus F.; Boulton, Christina; Castillo, Renan; Breazeale, Stephen; Schoonover, Carrie; Berger, Peter; Gitajn, I. Leah
• Is Part Of: Journal of orthopaedic trauma. Volume 33:Issue 5(2019)
• Publication Date: 2019-05
• Subjects: physical function -- independence -- geriatric patients -- high-energy trauma -- low-energy trauma; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000001436
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To evaluate physical function and return to independence of geriatric trauma patients, to compare physical function outcomes of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors of physical function outcomes. Design: Retrospective. Setting: Urban Level I trauma center. Patients: Study group of 216 patients with high-energy trauma and comparison group of 117 patients with low-energy trauma. Intervention: Injury mechanism (high- vs. low-energy mechanism). Main Outcome Measurement: Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) patient-reported outcome measure, and change in living situation and mobility. Results: Physical function outcomes and return to independence differed between patients with high-energy and low-energy injuries. High-energy geriatric trauma patients had significantly higher PROMIS PF scores compared with low-energy geriatric trauma patients (PROMIS PF score 42.2 ± 10.4 vs. 24.6 ± 10.4, P < 0.001). High-energy geriatric trauma patients were able to ambulate outdoors without an assistive device in 67% of cases and were living independently 74% of the time in comparison with 28% and 45% of low-energy geriatric trauma patients, respectively ( P < 0.001, P < 0.001). Multivariate linear regression analysis demonstrated that low-energy mechanism injury was independently associated with a 13.2 point reduction in PROMIS PF score ( P < 0.001). Conclusions: Geriatric patients greater than 1 year out from sustaining a high-energy traumatic injury seem to be functioning within the expected range for their age, whereas low-energy trauma patients seem to be functioning substantially worse than both age-adjusted norms and their high-energy cohorts. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.