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J Surg Res ; 259: 121-129, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33279837

RESUMO

BACKGROUND: Downhill skiing accounts for a large portion of geriatric sport-related trauma. We assessed the national burden of geriatric versus nongeriatric ski trauma. MATERIALS AND METHODS: Adults presenting to level 1/2 trauma centers after ski-associated injuries from 2011 to 2015 were identified from the National Trauma Data Bank by ICD-9 code. We compared demographics, injury patterns, and outcomes between geriatric (age ≥65 y) and nongeriatric adult skiers (age 18-64 y). A multiple regression analysis assessed for risk factors associated with severe injury (Injury Severity Score >15). RESULTS: We identified 3255 adult ski trauma patients, and 16.7% (543) were geriatric. Mean ages for nongeriatric versus geriatric skiers were 40.8 and 72.1 y, respectively. Geriatric skiers more often suffered head (36.7 versus 24.3%, P < 0.0001), severe head (abbreviated injury scale score >3, 49.0 versus 31.5%, P < 0.0001) and thorax injuries (22.2 versus 18.1%, P = 0.03) as compared with nongeriatric skiers. Geriatric skiers were also more often admitted to the ICU (26.5 versus 14.9%, P < 0.0001), discharged to a facility (26.7 versus 11.6%, P < 0.0001), and suffered higher mortality rates (1.3 versus 0.4%, P = 0.004). Independent risk factors for severe injury included being male (OR: 1.68, CI: 1.22-2.31), helmeted (OR: 1.41, CI: 1.07-1.85), and having comorbidities (OR: 1.37, CI: 1.05-1.80). Geriatric age was not independently associated with severe injury. CONCLUSIONS: At level 1/2 trauma centers, geriatric age in ski trauma victims was associated with unique injury patterns, higher acuity, increased rates of facility care at discharge, and higher mortality as compared with nongeriatric skiers. Our findings indicate the need for specialized care after high impact geriatric ski trauma.


Assuntos
Efeitos Psicossociais da Doença , Traumatismos Craniocerebrais/epidemiologia , Esqui/lesões , Traumatismos Torácicos/epidemiologia , Centros de Traumatologia/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Comorbidade , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/prevenção & controle , Bases de Dados Factuais , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Mortalidade Hospitalar , Humanos , Escala de Gravidade do Ferimento , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Esqui/estatística & dados numéricos , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/etiologia , Estados Unidos/epidemiologia , Adulto Jovem
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