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Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
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Defining geriatric trauma: when does age make a difference?

Nicholas W Goodmanson1, Matthew R Rosengart, Amber E Barnato

  • 1Division of General Surgery and Trauma, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.

Surgery
|October 2, 2012
PubMed
Summary
This summary is machine-generated.

Mortality risk in injured patients significantly increases starting at age 57. Trauma center (TC) care improves outcomes for older patients, suggesting an age threshold for TC triage is warranted.

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Area of Science:

  • Trauma Surgery
  • Geriatric Medicine
  • Public Health Policy

Background:

  • Elderly patients are undertriaged to trauma centers (TCs).
  • Defining the geriatric trauma patient age threshold is debated.
  • This study investigates age-related mortality risk and TC care effectiveness.

Purpose of the Study:

  • Identify the age at which mortality risk increases due to age alone.
  • Determine if TC care improves outcomes for older injured patients.
  • Estimate the impact of an age threshold on TC admissions.

Main Methods:

  • Retrospective cohort study of injured patients (age 19-100) in Pennsylvania (2001-2005).
  • Included patients with minimal injury (Injury Severity Score < 9).
  • Analyzed in-hospital mortality and age as a predictor using fractional polynomial method.

Main Results:

  • Mortality risk significantly increased at age 57 (OR 5.58).
  • TC care was associated with decreased mortality risk (OR 0.83).
  • An age threshold of 70 for triage would add ~1 admission/day to TCs.

Conclusions:

  • Age is a significant mortality risk factor in trauma.
  • TC care benefits older, minimally injured patients.
  • Consider an age threshold (e.g., 70) for TC triage to improve outcomes without substantial admission increase.