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Outcomes and health care resource utilization in super-elderly trauma patients
Kyla M Bennett1, John E Scarborough, Steven Vaslef
1Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Background:
Few studies have compared the post-injury outcomes of super-elderly patients to elderly patients.
Methods:
We performed a retrospective analysis of 1320 multi-trauma geriatric patients treated at a level I trauma center from 2003 through 2007. The outcomes of Super-Elderly (> or =80 years old; n = 422) and Elderly (60-79 years old; n = 898) patients were compared after adjustment for patient gender, mechanism of injury, Glasgow coma scale, injury severity score, and admission vital signs.
Results:
Super-elderly patients had significantly higher risk-adjusted in-hospital mortality compared with elderly patients [13.4% versus 7.7%, adjusted odds ratio = 1.94 (95% CI 1.14, 3.31), P = 0.015]. Of patients surviving hospitalization, super-elderly patients experienced shorter intensive care unit and hospital length of stay, but were more likely to require non-routine discharge (AOR 3.78 (2.75, 5.28), P < 0.0005). Super-elderly patients were more likely than elderly patients to die during hospitalization as a result of withdrawal of medical support (9.5% versus 5.5%, P = 0.007).
Conclusions:
Super-elderly patients have significantly greater risk-adjusted in-hospital mortality rates than elderly patients after injury, and are more likely to require non-routine discharge if they survive such injury.
