TY  - JOUR
PY  - 2023//
TI  - Configurations and outcomes of acute hospital care for frail and older patients with moderate to major trauma: a systematic review
JO  - BMJ open
A1  - Halter, Mary
A1  - Jarman, Heather
A1  - Moss, Phil
A1  - Kulnik, Stefan Tino
A1  - Baramova, Desislava
A1  - Gavalova, Lucia
A1  - Cole, Elaine
A1  - Crouch, Robert
A1  - Baxter, Mark
SP  - e066329
EP  - e066329
VL  - 13
IS  - 2
N2  - OBJECTIVE: To systematically review research on acute hospital care for frail or older adults experiencing moderate to major trauma. SETTING: Electronic databases (Medline, Embase, ASSIA, CINAHL Plus, SCOPUS, PsycINFO, EconLit, The Cochrane Library) were searched using index and key words, and reference lists and related articles hand-searched. INCLUDED ARTICLES: Peer-reviewed articles of any study design, published in English, 1999-2020 inclusive, referring to models of care for frail and/or older people in the acute hospital phase of care following traumatic injury defined as either moderate or major (mean or median Injury Severity Score ≥9). Excluded articles reported no empirical findings, were abstracts or literature reviews, or referred to frailty screening alone. <br><br>METHODS: Screening abstracts and full text, and completing data extractions and quality assessments using QualSyst was a blinded parallel process. A narrative synthesis, grouped by intervention type, was undertaken. OUTCOME MEASURES: Any outcomes reported for patients, staff or care system. <br><br>RESULTS: 17 603 references were identified and 518 read in full; 22 were included-frailty and major trauma (n=0), frailty and moderate trauma (n=1), older people and major trauma (n=8), moderate or major trauma (n=7) 0r moderate trauma (n=6). Studies were observational, heterogeneous in intervention and with variable methodological quality.Specific attention given to the care of older and/or frail people with moderate to major trauma in the North American context resulted in improvements to in-hospital processes and clinical outcomes, but highlights a relative paucity of evidence, particularly in relation to the first 48 hours post-injury. <br><br>CONCLUSIONS: This systematic review supports the need for, and further research into an intervention to address the care of frail and/or older patients with major trauma, and for the careful definition of age and frailty in relation to moderate or major trauma.     INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS PROSPERO: CRD42016032895.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2022-066329
ID  - ref1
ER  -