การศึกษาเปรียบเทียบปัจจัยที่เกี่ยวข้องกับภาวะช็อกจากการบาดเจ็บระหว่างผู้บาดเจ็บผู้ใหญ่และผู้สูงอายุ

Nongnuch Panhom; Wallada  Chanruangvanich; Prangtip  Chayaput; Orapan  Thosingha

Authors

Nongnuch Panhom Faculty of Nursing, Mahidol University
Wallada Chanruangvanich Faculty of Nursing, Mahidol University
Prangtip Chayaput Faculty of Nursing, Mahidol University
Orapan Thosingha Faculty of Nursing, Mahidol University

Keywords:

shock, adult and older adult injured patients, transportation time, injury severity, comorbidity

Abstract

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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