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J Korean Soc Emerg Med > Volume 20(2); 2009 > Article
Journal of The Korean Society of Emergency Medicine 2009;20(2): 177-184.
Factors Associated with the Severity of Injuries in Old Driver Trauma Patients
Dong Hyeon Lee, Sun Pyo Kim, SeongJung Kim, Soo Hyung Cho, Nam Soo Cho
Department of Emergency Medicine, College of Medicine, Chosun University, Gwangju, Korea. ksp93133@naver.com
As medicine has progressed, the human average lifetime has increased. Thus the number of geriatric patients has increased and, in particular, the number of older drivers has increased. Mortality rates for older trauma patients are higher than those for any other age group, but little research has been done about the severity of injuries to older patients involved in vehicle accidents. This study evaluated a number of factors and correlations involving old driver trauma patients.
We prospectively analyzed clinical information on 155 trauma patients over 65 years of age who were involved in vehicle accidents and visited the emergency department of Chosun University Hospital between Jan 2007 and Aug 2008. The following variables were examined for their ability to predict severity of injury: age, gender, vital signs, and mechanism of injury along with the Glasgow Coma Scale (GCS), the Abbreviated Injury Scale (AIS), and the Injury Severity Score(ISS). We divided the ISS scores into three groups: mild (1~8), moderate (9~15), and severe(above 16).
Most cases involved men (94.2%), and a majority involved agriculture (65.8%). The most common vehicle was the motorcycle (48.4%), and 51 (32.9%) patients were drunk at the time of the accident. Many had acquired their driver's licenses more than 30 years earlier (40.7%), and almost all of the patients (81.9%) never wore any safety devices. The patients who had multiple underlying diseases, coupled living type, low blood pressure at admittance, and more time since they had acquired their licenses scored higher on mean ISS than the other cases.
Old trauma patients had more longer admission days, had longer recovery times, and received more expensive treatment. For the same level of trauma, they took longer to heal than younger patients and experienced higher rates of mortality. Therefore, when the old driver trauma patients visit the emergency department, doctors need to perform more careful studies and provide a higher level of critical care. To lessen the number of old driver trauma patients, we should educate older drivers about safe driving methods and about the use of safety device, and we should enforce traffic laws and laws about drinking and driving.
Key words: Old driver trauma, Injury severity score (ISS), Vehicle trauma, Fatality
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