The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes
•The Palliative Performance Scale predicts mortality and one year functional outcomes in geriatric trauma patients•Almost half of geriatric trauma patients had a decline in functional status at one year from discharge•The majority of geriatric trauma patients report difficulty with their regular act...
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| Veröffentlicht in: | Injury 2023-09, Vol.54 (9), p.110957-110957, Article 110957 |
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| creator | Fiorentino, Michele Hwang, Franchesca Pentakota, Sri Ram Glass, Nina E. Livingston, David H. Mosenthal, Anne C. |
| description | •The Palliative Performance Scale predicts mortality and one year functional outcomes in geriatric trauma patients•Almost half of geriatric trauma patients had a decline in functional status at one year from discharge•The majority of geriatric trauma patients report difficulty with their regular activities and pain at one year from discharge
Frailty in trauma has been found to predict poor outcomes after injury including additional in-hospital complications, mortality, and discharge to dependent care. These gross outcome measures are insufficient when discussing long-term recovery as they do not address what is important to patients including functional status and quality of life. The purpose of this study is to determine if the Palliative Performance Scale (PPS) predicts mortality and functional status one year after trauma in geriatric patients.
Prospective observational study of trauma survivors, age ≥55 years. Patients were stratified by pre-injury PPS high (>70) or low (≤70). Outcomes were functional status at 1 year measured by Glasgow Outcome Scale Extended (GOSE), Euroqol-5D and SF-36. Adjusted relative risks (aRR) were obtained using modified Poisson regression
Follow-up was achieved on 215/301 patients. Mortality was 30% in low PPS group vs 8% in the high PPS group (P |
| doi_str_mv | 10.1016/j.injury.2023.110957 |
| format | Article |
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Frailty in trauma has been found to predict poor outcomes after injury including additional in-hospital complications, mortality, and discharge to dependent care. These gross outcome measures are insufficient when discussing long-term recovery as they do not address what is important to patients including functional status and quality of life. The purpose of this study is to determine if the Palliative Performance Scale (PPS) predicts mortality and functional status one year after trauma in geriatric patients.
Prospective observational study of trauma survivors, age ≥55 years. Patients were stratified by pre-injury PPS high (>70) or low (≤70). Outcomes were functional status at 1 year measured by Glasgow Outcome Scale Extended (GOSE), Euroqol-5D and SF-36. Adjusted relative risks (aRR) were obtained using modified Poisson regression
Follow-up was achieved on 215/301 patients. Mortality was 30% in low PPS group vs 8% in the high PPS group (P<0.001). A greater percentage of patients in the high group had a good functional outcome at one year compared to patients in the low group (78% vs 30% p<0.001). The high PPS patients were more likely to have improvement of GOSE at 1 year from discharge compared to low group (66% vs 27% P<0.001). Low PPS independently predicted poor functional outcome (aRR, 2.64; 95% confidence interval, 1.79-3.89) and death at 1 year (aRR, 3.64; 95% confidence interval 1.68-7.92). An increased percentage of low PPS patients reported difficulty with mobility (91% vs 46% p<0.0001) and usual activities (82% vs 56% p=0.002). Both groups reported pain (65%) and anxiety/depression (47%).
Low pre-Injury PPS predicts mortality and poor functional outcomes one year after trauma. Low PPS patients were more likely to decline, rather than improve. Regardless of PPS, most patients have persistent pain, anxiety, and limitations in performing daily activities.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2023.110957</identifier><identifier>PMID: 37532666</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Frailty ; Geriatric trauma ; Goals of care ; Long term outcomes ; Surgical Palliative care</subject><ispartof>Injury, 2023-09, Vol.54 (9), p.110957-110957, Article 110957</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c311t-ef159a5960b7f3c6a24b7a61d230ea929f12b3d845906885f1b06f29d76ee54c3</cites><orcidid>0000-0002-6821-4289 ; 0000-0001-8461-2749</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37532666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fiorentino, Michele</creatorcontrib><creatorcontrib>Hwang, Franchesca</creatorcontrib><creatorcontrib>Pentakota, Sri Ram</creatorcontrib><creatorcontrib>Glass, Nina E.</creatorcontrib><creatorcontrib>Livingston, David H.</creatorcontrib><creatorcontrib>Mosenthal, Anne C.</creatorcontrib><title>The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes</title><title>Injury</title><addtitle>Injury</addtitle><description>•The Palliative Performance Scale predicts mortality and one year functional outcomes in geriatric trauma patients•Almost half of geriatric trauma patients had a decline in functional status at one year from discharge•The majority of geriatric trauma patients report difficulty with their regular activities and pain at one year from discharge
Frailty in trauma has been found to predict poor outcomes after injury including additional in-hospital complications, mortality, and discharge to dependent care. These gross outcome measures are insufficient when discussing long-term recovery as they do not address what is important to patients including functional status and quality of life. The purpose of this study is to determine if the Palliative Performance Scale (PPS) predicts mortality and functional status one year after trauma in geriatric patients.
Prospective observational study of trauma survivors, age ≥55 years. Patients were stratified by pre-injury PPS high (>70) or low (≤70). Outcomes were functional status at 1 year measured by Glasgow Outcome Scale Extended (GOSE), Euroqol-5D and SF-36. Adjusted relative risks (aRR) were obtained using modified Poisson regression
Follow-up was achieved on 215/301 patients. Mortality was 30% in low PPS group vs 8% in the high PPS group (P<0.001). A greater percentage of patients in the high group had a good functional outcome at one year compared to patients in the low group (78% vs 30% p<0.001). The high PPS patients were more likely to have improvement of GOSE at 1 year from discharge compared to low group (66% vs 27% P<0.001). Low PPS independently predicted poor functional outcome (aRR, 2.64; 95% confidence interval, 1.79-3.89) and death at 1 year (aRR, 3.64; 95% confidence interval 1.68-7.92). An increased percentage of low PPS patients reported difficulty with mobility (91% vs 46% p<0.0001) and usual activities (82% vs 56% p=0.002). Both groups reported pain (65%) and anxiety/depression (47%).
Low pre-Injury PPS predicts mortality and poor functional outcomes one year after trauma. Low PPS patients were more likely to decline, rather than improve. Regardless of PPS, most patients have persistent pain, anxiety, and limitations in performing daily activities.</description><subject>Frailty</subject><subject>Geriatric trauma</subject><subject>Goals of care</subject><subject>Long term outcomes</subject><subject>Surgical Palliative care</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKxDAUhoMoOl7eQCRLN625tGnrQpDBUWFgBMeFq5CmJ5jSiyapMG9vpOpSziJw8v35yYfQOSUpJVRctakd2sntUkYYTyklVV7soQUtiyohTBT7aEEIIwnlJT9Cx963hNCCcH6IjniRcyaEWCCzfQN8D86q4KzGTypYGALeDIBfQTl8awI4vHVq6tV1vO66SNpPwE_gzOh6NWjAz1p1ceOgsTp4vJoGHew4qA5vpqDHHvwpOjCq83D2c56gl9XddvmQrDf3j8vbdaI5pSEBQ_NK5ZUgdWG4FopldaEEbRgnoCpWGcpq3pRZXhFRlrmhNRGGVU0hAPJM8xN0Ob_77saPCXyQvfUauk4NME5eshgVcWge0WxGtRu9d2Dku7O9cjtJifw2LFs5G5bfhuVsOMYufhqmuofmL_SrNAI3MwDxn58WnPQ6OtVRjgMdZDPa_xu-AP8Ojn8</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Fiorentino, Michele</creator><creator>Hwang, Franchesca</creator><creator>Pentakota, Sri Ram</creator><creator>Glass, Nina E.</creator><creator>Livingston, David H.</creator><creator>Mosenthal, Anne C.</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6821-4289</orcidid><orcidid>https://orcid.org/0000-0001-8461-2749</orcidid></search><sort><creationdate>202309</creationdate><title>The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes</title><author>Fiorentino, Michele ; Hwang, Franchesca ; Pentakota, Sri Ram ; Glass, Nina E. ; Livingston, David H. ; Mosenthal, Anne C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-ef159a5960b7f3c6a24b7a61d230ea929f12b3d845906885f1b06f29d76ee54c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Frailty</topic><topic>Geriatric trauma</topic><topic>Goals of care</topic><topic>Long term outcomes</topic><topic>Surgical Palliative care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fiorentino, Michele</creatorcontrib><creatorcontrib>Hwang, Franchesca</creatorcontrib><creatorcontrib>Pentakota, Sri Ram</creatorcontrib><creatorcontrib>Glass, Nina E.</creatorcontrib><creatorcontrib>Livingston, David H.</creatorcontrib><creatorcontrib>Mosenthal, Anne C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fiorentino, Michele</au><au>Hwang, Franchesca</au><au>Pentakota, Sri Ram</au><au>Glass, Nina E.</au><au>Livingston, David H.</au><au>Mosenthal, Anne C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2023-09</date><risdate>2023</risdate><volume>54</volume><issue>9</issue><spage>110957</spage><epage>110957</epage><pages>110957-110957</pages><artnum>110957</artnum><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>•The Palliative Performance Scale predicts mortality and one year functional outcomes in geriatric trauma patients•Almost half of geriatric trauma patients had a decline in functional status at one year from discharge•The majority of geriatric trauma patients report difficulty with their regular activities and pain at one year from discharge
Frailty in trauma has been found to predict poor outcomes after injury including additional in-hospital complications, mortality, and discharge to dependent care. These gross outcome measures are insufficient when discussing long-term recovery as they do not address what is important to patients including functional status and quality of life. The purpose of this study is to determine if the Palliative Performance Scale (PPS) predicts mortality and functional status one year after trauma in geriatric patients.
Prospective observational study of trauma survivors, age ≥55 years. Patients were stratified by pre-injury PPS high (>70) or low (≤70). Outcomes were functional status at 1 year measured by Glasgow Outcome Scale Extended (GOSE), Euroqol-5D and SF-36. Adjusted relative risks (aRR) were obtained using modified Poisson regression
Follow-up was achieved on 215/301 patients. Mortality was 30% in low PPS group vs 8% in the high PPS group (P<0.001). A greater percentage of patients in the high group had a good functional outcome at one year compared to patients in the low group (78% vs 30% p<0.001). The high PPS patients were more likely to have improvement of GOSE at 1 year from discharge compared to low group (66% vs 27% P<0.001). Low PPS independently predicted poor functional outcome (aRR, 2.64; 95% confidence interval, 1.79-3.89) and death at 1 year (aRR, 3.64; 95% confidence interval 1.68-7.92). An increased percentage of low PPS patients reported difficulty with mobility (91% vs 46% p<0.0001) and usual activities (82% vs 56% p=0.002). Both groups reported pain (65%) and anxiety/depression (47%).
Low pre-Injury PPS predicts mortality and poor functional outcomes one year after trauma. Low PPS patients were more likely to decline, rather than improve. Regardless of PPS, most patients have persistent pain, anxiety, and limitations in performing daily activities.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>37532666</pmid><doi>10.1016/j.injury.2023.110957</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-6821-4289</orcidid><orcidid>https://orcid.org/0000-0001-8461-2749</orcidid></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Frailty Geriatric trauma Goals of care Long term outcomes Surgical Palliative care |
| title | The Geriatric Patient One Year After Trauma: Palliative Performance Scale Predicts Functional Outcomes |
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