Abstract
Introduction: Traumatic injury is a leading cause of death and disability in adults ≥ 65 years old, but
there are few epidemiological studies addressing this issue. The aim of this study was to assess how
characteristics of blunt traumatic injuries in adults ≥ 65 vary by age.
Methods: Using data from the a single-state trauma registry, this retrospective cohort study examined
injured patients ≥ 65 admitted to all Level I and Level II trauma centers in Pennsylvania between
2011 and 2014 (n=38,562). Patients were stratified by age into three subgroups (age 65-74;
75-84; ≥85). We compared demographics, injury, and system-level across groups.
Results: We found significant increases in the proportion of female gender, (48.6% vs. 58.7% vs.
67.7%), white race (89.1% vs. 92.6% vs. 94.6%), and non-Hispanic ethnicity (97.5% vs. 98.6% vs.
99.4%) across advancing age across age groups, respectively. As age increased, the proportion of
falls (69.9% vs. 82.1% vs. 90.3%), in-hospital mortality (4.6% vs. 6.2% vs. 6.8%), and proportion of
patients arriving to the hospital via ambulance also increased (73.6% vs. 75.8% vs. 81.1%), while
median injury severity plateaued (9.0% all groups) and the proportion of Level I trauma alerts (10.6%
vs. 8.2% vs. 6.7%) decreased. We found no trend between age and patient transfer status. The five
most common diagnoses were vertebral fracture, rib fracture, head contusion, open head wound,
and intracranial hemorrhage, with vertebral fracture and head contusion increasing with age, and rib
fracture decreasing with age.
Conclusion: In a large cohort of older adults with trauma (n= 38,000), we found, with advancing age,
a decrease in trauma alert level, despite an increase in mortality and a decrease in demographic
diversity. This descriptive study provides a framework for future research on the relationship between
age and blunt traumatic injury in older adults.
Citation
ID:
157028
Ref Key:
earl-royal2016westernvariation