Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jan;149(1):83-9.
doi: 10.1001/jamasurg.2013.4244.

Long-term postinjury functional recovery: outcomes of geriatric consultation

Areti Tillou  1 , Lorraine Kelley-Quon  1 , Sigrid Burruss  1 , Eric Morley  2 , Henry Cryer  1 , Marilyn Cohen  1 , Lillian Min  3
Affiliations

Long-term postinjury functional recovery: outcomes of geriatric consultation

Areti Tillou et al. JAMA Surg. 2014 Jan.

Abstract

Importance: Functional recovery is an important outcome following injury. Functional impairment is persistent in the year following injury for older trauma patients.

Objective: To measure the impact of routine geriatric consultation on functional outcomes in older trauma patients.

Design, setting, and participants: In this pretest-posttest study, the pretest control group (n = 37) was retrospectively identified (December 2006-November 2007). The posttest geriatric consultation (GC) group (n = 85) was prospectively enrolled (December 2007-June 2010). We then followed up both groups for 1 year after enrollment. This study was conducted at an academic level 1 trauma center with adults 65 years of age and older admitted as an activated code trauma.

Intervention: Routine GC.

Main outcomes and measures: The Short Functional Status survey of 5 activities of daily living (ADLs) at hospital admission and 3, 6, and 12 months postinjury.

Results: The unadjusted Short Functional Status score (GC group only) declined from 4.6 preinjury to 3.7 at 12 months postinjury, a decline of nearly 1 full ADL (P < .05). The ability to shop for personal items was the specific ADL more commonly retained by the GC group compared with the control group. The GC group had a better recovery of function in the year following injury than the GC group, controlling for age, sex, race/ethnicity, length of stay, comorbidity, injury severity, postdischarge rehabilitation, complication, and whether surgery was performed (P < .01), a difference of 0.67 ADL abilities retained by the GC group compared with the control group (95% CI, 0.06-1.4).

Conclusions and relevance: Functional recovery for older adults following injury may be improved by GC. Early introduction of multidisciplinary care in geriatric trauma patients warrants further investigation.

PubMed Disclaimer

Conflict of interest statement

Interim results of this research were presented at the Annual Scientific Meeting, Association for the Surgery of Trauma, Boston, MA, September 2010 and full results will be presented at the American Geriatrics Society Annual Scientific Meeting on May 3, 2013.

There are no relevant conflicts of interest.

Figures

Figure 1
Figure 1
Data Flow, Retrospective Control Group versus Prospective Geriatric Consult Group
Figure 2
Figure 2
* Bootstrapped 95% confidence intervals around the 12-month mean ADL-count change from baseline for consult group (−.35, −1) versus control group (−1.05, −1.8) were non-overlapping. There were 122 unique patients in the model, who were observed at 3 months (n=86), 6 months (n=87), and 12 months (n=92).
See this image and copyright information in PMC

Comment in

References

    1. Rzepka SG, Malangoni MA, Rimm AA. Geriatric trauma hospitalization in the United States: a population-based study. J Clin Epidemiol. 2001;54(6):627–633. - PubMed
    1. Campbell PR. Population projections for states by age, sex, race, and Hispanic origin: 1995 to 2025. Population Projections Branch, Population Division, US Bureau of the Census; 1996.
    1. Givens JL, Sanft TB, Marcantonio ER. Functional recovery after hip fracture: the combined effects of depressive symptoms, cognitive impairment, and delirium. J Am Geriatr Soc. 2008;56(6):1075–1079. - PubMed
    1. Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet. 1999;353(9147):93–97. - PubMed
    1. Taylor MD, Tracy JK, Meyer W, Pasquale M, Napolitano LM. Trauma in the elderly: intensive care unit resource use and outcome. J Trauma. 2002;53(3):407–414. - PubMed

Publication types