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Epidemiology of Orthopedic Trauma in The Geriatric Population of Karachi, Pakistan
Keywords:
the etiology, various mechanisms of injury and outcome of orthopedic traumaAbstract
Objective: To study the etiology, various mechanisms of injury and outcome of orthopedic trauma in elderly patients presenting to the Emergency Department of a tertiary care hospital.
Methods: The data was prospectively collected over a period of 1 year (Jan 2015-Dec 2015) at the Jinnah Postgraduate Medical Centre’s orthopaedic bay in the Emergency Department. 692 elderly trauma-patients above 65 years were included. The doctors on duty filled out a simple questionnaire for every patient that presented with orthopedic injury. Statistical analysis was done using SPSS version 20.
Results: Falls on the same plane were the most common cause of injury at 67.1% (n=464), while road traffic accidents were the second most common accounting for 22.55% (n= 156), and alarmingly third came gunshot injuries at 2.3 % (n=16). The most common site of injury due to falls was the lower limb at 43.9% (n=304) while the upper limb was 23.1% (n =160). Of the fall injuries, 81.9% (n=464) had a fall on the same plane while 18.1% (n=84) had a fall from 10 feet or higher.
Conclusion: The percentage of elderly patients amongst the general population is increasing day by day and so is the risk for trauma. Aggressive management to counteract this increase in geriatric trauma is required, along with sensitivity to issues such as elder abuse. An emphasis on nationwide policies and state run programs for elder citizens regarding healthcare and primary disease prevention as well as their rehabilitation will serve to reduce the burden on an already poverty stricken nation.
References
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24. Cambell AJ. Borrie MJ. Spears GF. Jackson SL. Brown JS. Ftizgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990 Mar;19:136-41.
25. Malik AM. Dal NA. Talpur KAH. Road Traffic Injuries and their Outcome in the Elderly Patients (60 years and above). Does Age make a Difference? J Trauma Treat 2012 Jan;1:129.
26. Osler T. Hales K. Baack B. Bear K. Hsi K. Pathak D. et al. Trauma in the elderly. Am J Surg. 1988 Dec;156: 537-543.
27. Schiller WR. Knox R. Chleborad W. A five-year experience with severe injuries in elderly patients. Accid Anal Prev1995 Apr;27: 167-174.
28. Perdue PW. Watts DD. Kaufmann CR. Trask AL Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma 1998 Oct;45: 805-810.
29. Santora TA. Schinco MA. Trooskin SZ. Management of trauma in the elderly patient. Surg Clin North Am 1994 Feb;74: 163-186.
30. Adam SH. Eid HO. Barss P. Lunsigo K. Grivina M. Torab FC et al. Epidiomology of Geriatirc trauma in united Arab Emirates. Arch Gerontol Geriatr. 2008. Nov-Dec;47(3):377-82.
31. Hofman K. Primack A. Keusch, G. Hrynkow S. Addressing the growing burden of trauma and injury in low-and middle-income countries. American Journal of Public Health. 2005 Jan;95(1) 13–17.
32. Streib EW. Hackworth J. Hay Ward TZ. Firearm suicide: use of firearm injuries and death surveillance system. J Trauma 2007 Mar;3:730–4.
33. Lustenberger T. Inaba K. Schnüriger B. Barmparas G. Eberle BM. Lam L. et al. Gunshot injuries in the elderly: patterns and outcomes. A national trauma databank analysis. World J Surg. 2011 Mar;35(3):528-34.
34. Chalya PL. Mabula JB. Dass RM. Ngayomela IH. Chandika AB. Mbelenge N. et al. Major limb amputations: A tertiary hospital experience in northwestern Tanzania. J Orthop Surg Res. 2012;7(1):18.
2. Nagy KK, Smith RF, Roberts RR, Joseph KT, An GC, Bokhari F. et al. Prognosis of penetrating trauma in elderly patients: a comparison with younger patients. J Trauma 2000 Aug 49(2);190-193.
3. Mann NC. Cahn RM. Mullins RJ. Brand DM. Jurkovisch GH. Survival among injured geriatric patients during construction of a statewide trauma system. J Trauma. 2001 Jun 50(6);1111-1116.
4. Howden LM, Meyer JA. Age and sex composition: 2010. 2010 Census Briefs, US Department of Commerce, Economics and Statistics Administration. US CENSUS BUREAU. Issued May 2011.
5. Broos PL. D’Hoore A. Vanderschot P. Rommens PM. Stappaerts KH. Multiple trauma in elderly patients. Factors influencing outcome: importance of aggressive care. Injury. 1993 Jul;24(6):365-368.
6. McGwin G Jr. Melton SM. May AK. Rue LW. Long-term survival in the elderly after trauma. J Trauma. 2000 Sep;49(3):470-476.
7. Jemal A. Ward E. Hao Y. Thun M. Trends in the leading causes of death in the United States, 1970-2002. JAMA. 2005 Sep;10(294): 1255-1259.
8. Champion HR. Copes WS. Sacco WJ. Lawnick MM. Keast SL. Bain LW Jr, et al. The Major Trauma Outcome Study: establishing national norms for trauma care. J Trauma. 1990 Nov;30(11):1356-1365.
9. Morris JA. MacKenzie EJ. Damiano AM. Bass SM. Mortality in trauma patients: the interaction between host factors and severity. J Trauma. 1990 Dec;30(12):1476-1482.
10. Pellicane JV, Byrne K, DeMaria EJ. Preventable complications and death from multiple organ failure among geriatric trauma victims. J Trauma. 1992 Sep;33(3):440-444.
11. Murray CJ. Lopez AD. World Health Organization. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020...
12. Spiegel DA. Gosselin RA. Coughlin RR. Joshipura M. Browner BD. Dormans JP. The burden of musculoskeletal injury in low and middle-income countries: challenges and opportunities. JBJS. 2008 Apr 1;90(4):915-23.
13. Emro.who.int. (2017). WHO EMRO | Pakistan | Countries. [online] Available at: http://www.emro.who.int/countries/pak/index.html [Accessed 24 Jul. 2017].
14. Hashmi Z. Danish SH. Ahmad F. Hashmi M. Falls in Geriatric Population- A cross sectional study for assessment of the risk factors. J Dow Uni Health Sci 2013; 7(3):94-100.
15. World Health Organization. (2017). Global Health Estimates. [online] Available at: http://www.who.int/healthinfo/bodproject/en/index.html [Accessed 24 Jul. 2017].
16. Ferrera PC. Bartfield JM. D'Andrea CC. Outcomes of admitted geriatric trauma victims. Am J Emerg Med. 2000 Sep;18(5):575-80.
17. Gowing R. Jain MK. Injury patterns and outcomes associated with elderly trauma victims in Kingston, Ontario. Can J Surg. 2007 Dec; 50(6): 437–444.
18. Gomberg BF. Gruen GS. Smith WR. Spott M. Outcomes in acute orthopaedic trauma: a review of 130,506 patients by age. Injury 1999 Aug;30: 431-7.
19. Malik MR. Azeem M. Iqbal MZ. Orthopaedic injuries among elderly persons; frequency and assessment of the risk factors. Professional Med J Dec 2011;18(4):615-620.
20. Gabell A. Simons MA. Nayak US. Falls in the healthy elderly: predisposing causes. Ergonomics1985 Jul;28:965-9.
21. Prudham D. Evans JG. Factors associated with falls in the elderly: a community study. Age Ageing 1981 Aug;10:141-6.
22. Sattin RW. Lambert-Huber DA. Devito CA. Rodriguez JG. Ros A. Bacchelli S et al. The incidence of fall injury events among the elderly in a defined population. Am J Epidemiol 1990 Jun;131:1028-37.
23. Wolfson L. Whipple R. Derby CA Amerman P. Nashner L Gender differences in the balance of healthy elderly as demonstrated by dynamic posturography. J Gerontol Med Sci 1994 Jul;49:160-7.
24. Cambell AJ. Borrie MJ. Spears GF. Jackson SL. Brown JS. Ftizgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990 Mar;19:136-41.
25. Malik AM. Dal NA. Talpur KAH. Road Traffic Injuries and their Outcome in the Elderly Patients (60 years and above). Does Age make a Difference? J Trauma Treat 2012 Jan;1:129.
26. Osler T. Hales K. Baack B. Bear K. Hsi K. Pathak D. et al. Trauma in the elderly. Am J Surg. 1988 Dec;156: 537-543.
27. Schiller WR. Knox R. Chleborad W. A five-year experience with severe injuries in elderly patients. Accid Anal Prev1995 Apr;27: 167-174.
28. Perdue PW. Watts DD. Kaufmann CR. Trask AL Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma 1998 Oct;45: 805-810.
29. Santora TA. Schinco MA. Trooskin SZ. Management of trauma in the elderly patient. Surg Clin North Am 1994 Feb;74: 163-186.
30. Adam SH. Eid HO. Barss P. Lunsigo K. Grivina M. Torab FC et al. Epidiomology of Geriatirc trauma in united Arab Emirates. Arch Gerontol Geriatr. 2008. Nov-Dec;47(3):377-82.
31. Hofman K. Primack A. Keusch, G. Hrynkow S. Addressing the growing burden of trauma and injury in low-and middle-income countries. American Journal of Public Health. 2005 Jan;95(1) 13–17.
32. Streib EW. Hackworth J. Hay Ward TZ. Firearm suicide: use of firearm injuries and death surveillance system. J Trauma 2007 Mar;3:730–4.
33. Lustenberger T. Inaba K. Schnüriger B. Barmparas G. Eberle BM. Lam L. et al. Gunshot injuries in the elderly: patterns and outcomes. A national trauma databank analysis. World J Surg. 2011 Mar;35(3):528-34.
34. Chalya PL. Mabula JB. Dass RM. Ngayomela IH. Chandika AB. Mbelenge N. et al. Major limb amputations: A tertiary hospital experience in northwestern Tanzania. J Orthop Surg Res. 2012;7(1):18.
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Published
2017-09-05
How to Cite
Kanaan1, M., & Ali Ahmad3, Anisuddin Bhatti3, S. S. R. K. (2017). Epidemiology of Orthopedic Trauma in The Geriatric Population of Karachi, Pakistan. Journal of Pakistan Orthopaedic Association, 29(2), 48–53. Retrieved from http://mail.jpoa.org.pk/index.php/upload/article/view/10
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