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Old age as a criterion for trauma team activation
1Department of Surgery, Division of Trauma and Critical Care, University of Southern California, Keck School of Medicine, Los Angeles, California, USA. demetria@hsc.ucla.edu
The Journal of Trauma
|October 5, 2001
Summary
Elderly trauma patients face higher mortality risks. Age 70 or older should be a criterion for trauma team activation (TTA) to improve outcomes for these vulnerable patients.
Area of Science:
- Trauma Surgery
- Geriatric Medicine
- Emergency Medicine
Background:
- Elderly trauma patients exhibit a poorer prognosis compared to younger individuals.
- Current trauma team activation (TTA) protocols do not typically use age as a sole criterion.
- This study investigates the efficacy of incorporating advanced age as a TTA criterion.
Purpose of the Study:
- To evaluate the impact of age 70 years or older as a criterion for trauma team activation (TTA).
- To determine if TTA criteria adequately identify elderly trauma patients who would benefit from immediate, specialized care.
- To assess the outcomes of elderly trauma patients based on adherence to existing TTA criteria.
Main Methods:
- A trauma registry study was conducted, focusing on injured patients aged 70 years and above.
- Patients were categorized based on whether they met standard TTA criteria.
- Benefit from TTA was assumed for patients with in-hospital mortality, ICU admission within 24 hours, or requiring non-orthopedic surgery.
Main Results:
- Over 7.5 years, 883 elderly patients (>=70 years) were admitted; 25% met standard TTA criteria, with 50% mortality and 39% ICU admission.
- The 75% of patients not meeting standard TTA criteria had lower mortality (16%) and ICU admission (24%).
- A significant proportion of elderly patients with severe injuries (ISS > 15) or critical injuries (ISS > 30) did not meet standard hemodynamic TTA criteria.
Conclusions:
- Elderly trauma patients demonstrate high mortality rates, even with less severe injuries.
- Standard TTA criteria frequently fail to identify elderly patients with severe injuries who require specialized care.
- Implementing age 70 years or older as an independent criterion for TTA is recommended to improve care and outcomes.
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