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Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center

The aim of this study is to determine the critical time intervals and influencing covariates for in-hospital mortality in geriatric trauma and orthopedic patients. During a period of five years, we retrospectively review patients aged > 60 years who were hospitalized at the Department of Trauma,...

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Autores principales: Höller, Sebastian, Wübbeke, Lina F., Apel, Jamina, Hawellek, Thelonius, Sehmisch, Stephan, Wiedenhöft, John, Lehmann, Wolfgang, Hoffmann, Daniel B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218915/
https://www.ncbi.nlm.nih.gov/pubmed/37240572
http://dx.doi.org/10.3390/jcm12103466
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author Höller, Sebastian
Wübbeke, Lina F.
Apel, Jamina
Hawellek, Thelonius
Sehmisch, Stephan
Wiedenhöft, John
Lehmann, Wolfgang
Hoffmann, Daniel B.
author_facet Höller, Sebastian
Wübbeke, Lina F.
Apel, Jamina
Hawellek, Thelonius
Sehmisch, Stephan
Wiedenhöft, John
Lehmann, Wolfgang
Hoffmann, Daniel B.
author_sort Höller, Sebastian
collection PubMed
description The aim of this study is to determine the critical time intervals and influencing covariates for in-hospital mortality in geriatric trauma and orthopedic patients. During a period of five years, we retrospectively review patients aged > 60 years who were hospitalized at the Department of Trauma, Orthopedic, and Plastic Surgery. The primary outcome is the mean time to death. Survival analysis is performed using an accelerated failure time model. A total of 5388 patients are included in the analysis. Two-thirds underwent surgery (n = 3497, 65%) and one-third were conservatively treated (n = 1891, 35%). The in-hospital mortality rate is 3.1% (n = 168; surgery, n = 112; conservative, n = 56). The mean time to death is 23.3 days (±18.8) after admission in the surgery group and 11.3 days (±12.5) in the conservative treatment group. The greatest accelerating effect on mortality is found in the intensive care unit (16.52, p < 0.001). We are able to identify a critical time interval for in-hospital mortality between days 11 and 23. The day of death on weekend days/holidays, hospitalization for conservative treatment, and treatment at the intensive care unit significantly increase the risk of in-hospital mortality. Early mobilization and a short hospitalization duration seem to be of major importance in fragile patients.
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spelling pubmed-102189152023-05-27 Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center Höller, Sebastian Wübbeke, Lina F. Apel, Jamina Hawellek, Thelonius Sehmisch, Stephan Wiedenhöft, John Lehmann, Wolfgang Hoffmann, Daniel B. J Clin Med Article The aim of this study is to determine the critical time intervals and influencing covariates for in-hospital mortality in geriatric trauma and orthopedic patients. During a period of five years, we retrospectively review patients aged > 60 years who were hospitalized at the Department of Trauma, Orthopedic, and Plastic Surgery. The primary outcome is the mean time to death. Survival analysis is performed using an accelerated failure time model. A total of 5388 patients are included in the analysis. Two-thirds underwent surgery (n = 3497, 65%) and one-third were conservatively treated (n = 1891, 35%). The in-hospital mortality rate is 3.1% (n = 168; surgery, n = 112; conservative, n = 56). The mean time to death is 23.3 days (±18.8) after admission in the surgery group and 11.3 days (±12.5) in the conservative treatment group. The greatest accelerating effect on mortality is found in the intensive care unit (16.52, p < 0.001). We are able to identify a critical time interval for in-hospital mortality between days 11 and 23. The day of death on weekend days/holidays, hospitalization for conservative treatment, and treatment at the intensive care unit significantly increase the risk of in-hospital mortality. Early mobilization and a short hospitalization duration seem to be of major importance in fragile patients. MDPI 2023-05-15 /pmc/articles/PMC10218915/ /pubmed/37240572 http://dx.doi.org/10.3390/jcm12103466 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Höller, Sebastian
Wübbeke, Lina F.
Apel, Jamina
Hawellek, Thelonius
Sehmisch, Stephan
Wiedenhöft, John
Lehmann, Wolfgang
Hoffmann, Daniel B.
Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title_full Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title_fullStr Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title_full_unstemmed Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title_short Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
title_sort retrospective in-hospital mortality analysis of geriatricpatients treated in a level 1 trauma center
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218915/
https://www.ncbi.nlm.nih.gov/pubmed/37240572
http://dx.doi.org/10.3390/jcm12103466
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