دورية أكاديمية
GIFTS: Geriatric Intensive Functional Therapy Sessions-for the older trauma patient.
العنوان: | GIFTS: Geriatric Intensive Functional Therapy Sessions-for the older trauma patient. |
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المؤلفون: | Wintz D; From the Sharp HealthCare, Sharp Memorial Hospital Trauma and Acute Care Surgery, San Diego, California., Schaffer KB, Hites JJ, Wybourn C, Bui EH, Langness S, Hamel M, Wright K, Frey JR |
المصدر: | The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2024 Aug 01; Vol. 97 (2), pp. 197-204. Date of Electronic Publication: 2023 Dec 04. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins |
مواضيع طبية MeSH: | Trauma Centers* , Wounds and Injuries*/therapy , Wounds and Injuries*/complications, Humans ; Male ; Female ; Aged ; Pilot Projects ; Retrospective Studies ; Aged, 80 and over ; Physical Therapy Modalities ; Geriatric Assessment ; Length of Stay/statistics & numerical data ; Occupational Therapy/methods |
مستخلص: | Background: Considering resources for comprehensive geriatric care, it would be beneficial for geriatric trauma patients (GTPs) and medical patients to be comanaged in one program focusing on ancillary therapeutics (AT): physical therapy, occupational therapy, speech language pathology, respiratory therapy, and sleep wake hygiene. This pilot study describes outcomes of GTPs in a hospital-wide program focused on geriatric-specific AT. Methods: Geriatric trauma patients and geriatric patients were screened by program coordinator for enrollment at one Level II trauma center from August 2021 to December 2022. Enrolled patients (EPs) were admitted to trauma or medicine floors and received repetitive AT with attention to sleep wake hygiene throughout hospitalization and compared with similar nonenrolled patients (NEPs). Excluded patients had any of the following: indication of geriatric syndrome with a fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) score of 5, no frailty with a FRAIL score of 0, comfort focused plans, or arrived from skilled care. Retrospective chart review of demographics and outcomes was completed for both EPs and NEPs. Results: A total of 224 EPs (28 trauma [TR]) were compared with 574 NEPs (148 TR). Enrolled patients showed shorter length of stay (mean, 3.8 vs. 6.1; p = 0.0001), less delirium (3.1% vs. 9.6%, p = 0.00222), less time to ambulation (13 hours vs. 39 hours, p = 0.0005), and higher likelihood to discharge home (56% vs. 27%, p < 0.0001) as compared with NEPs. The median FRAIL score was 3 for both groups. Enrolled medical patients ambulated the soonest at 11 average hours, compared with 23 hours for enrolled trauma patients and 39 hours for NEPs. There were zero delirium events among enrolled trauma patients; 25% was found among nonenrolled trauma patients ( p = 0.00288). Conclusion: Despite a small trauma cohort, results support feasibility to include GTPs in hospital-wide programs with geriatric-specific AT. Mobility and cognitive strategies may improve opportunities to avoid delirium, decrease length of stay, and influence more frequent disposition to home. Level of Evidence: Therapeutic/Care Management; Level III. (Copyright © 2023 American Association for the Surgery of Trauma.) |
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تواريخ الأحداث: | Date Created: 20231205 Date Completed: 20240725 Latest Revision: 20240822 |
رمز التحديث: | 20240823 |
DOI: | 10.1097/TA.0000000000004224 |
PMID: | 38051122 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2163-0763 |
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DOI: | 10.1097/TA.0000000000004224 |