Long-term outcomes after injury in the elderly

The lasting impact of injury on lifestyle in the elderly remains poorly defined. The purpose of this study was to determine the long-term quality-of-life outcomes in elderly trauma patients.

The trauma registry at a regional trauma center was used to identify hospital survivors of injury > or = 65 years old discharged from April 1996 to March 1999. The 36-Item Short Form (SF-36) Health Survey was administered to this group by telephone interview and the scores compared with age-adjusted Canadian norms. Comparisons with test were made for continuous data.

Complete data collection was achieved in 128 of 171 (75%) study patients. The mean Injury Severity Score was 21, the mean initial Glasgow Coma Scale score was 13, and the mean age was 74. Most (97%) were victims of blunt trauma. Compared with Canadian age-adjusted norms, there was a significant (p < 0.05) decrease in seven of eight SF-36 domains: Physical Functioning, Role-Physical and Role-Emotional (limitations secondary to physical and emotional health), Social Functioning, Mental Health, Vitality, and General Health. Before injury, most (98%) were living independently at home. However, at long-term follow-up (mean, 2.8 years; range, 1.5-4.5 years), only 63% were living independently and 20% still required home care.

Although the majority of elderly injury survivors achieve independent living, long-term follow-up indicates significant residual disability in quality of life as measured by the SF-36.