Comparative Study of Factors Related to Traumatic Shock Between Adult and Older Adult Injured Patients
Keywords:shock, adult and older adult injured patients, transportation time, injury severity, comorbidity
Objective: To compare between adult and older adult injured patients’ traumatic shock in relation to the factors of transportation time, severity of injury (SI), and comorbidity
Design: Cross-sectional study
Methodology: The sample consisted of 209 injured patients aged 18 and above, treated in a trauma and emergency department. The research instruments were: 1) a demographic and injury history form; and 2) a record form for transportation time, injury severity score (ISS), comorbidity, shock index, and age shock index. The data were analysed using the Mann-Whitney U test, Chi-square, and the binary logistic regression, with the significance level set at 0.05.
Results: The majority of the subjects (70.81%) were adults, with the leading causes of injury being falls from height (42.62%) and traffic accidents (31.75%), respectively (χ2 = 14.85, p < .01). Occurrence of traumatic shock was more common in injured older adults than in injured adults (73.77% VS 22.97%; OR = 7.67, 95% CI = 3.35-17.58, p < .01). In most cases (69.38%), the transportation time did not exceed 60 minutes, and had no significant relationship to shock (χ2 = 2.21, p = .14). Both the adult and older adult injured patients displayed mild degrees of injury on the ISS (55.74% VS 67.57%). Shock was most frequent in cases with an ISS score of under 15, and significantly more common in older adults than in adults (85.71% VS 57.89%). Comorbidity was identified as a factor more significantly related to shock in older adult than in adult injured patients (75.00% VS 33.33%). Also, injury severity degrees were significantly related to, and also influenced, occurrence of shock (χ2 = 25.01, p < .01; OR = 4.70, 95% CI = 2.04-10.83; OR = 9.34, 95% CI = 3.37-25.87; p < .01). Comorbidity, on the other hand, was significantly related to shock (χ2 = 16.83; p < .01) but was not found to influence it.
Recommendations: Because age and injury severity could influence shock in older adult patients, nurses are advised to take these two factors into careful consideration to plan for appropriate caregiving.
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