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Older trauma patients face a significantly higher risk of failure to rescue (FTR), defined as death after complications. This risk escalates with both increasing age and the number of in-hospital complications experienced.

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Area of Science:

  • Trauma Surgery
  • Geriatric Medicine
  • Healthcare Quality Improvement

Background:

  • Failure to rescue (FTR) is a critical indicator of hospital quality.
  • The impact of advanced age on FTR risk following trauma is not well-defined.
  • Understanding age-related FTR risk is essential for improving outcomes in elderly trauma patients.

Purpose of the Study:

  • To investigate the association between advanced age and the risk of failure to rescue in trauma patients.
  • To identify age as a predictor of FTR in the trauma population.
  • To quantify the increased risk of FTR in older adults with traumatic injuries.

Main Methods:

  • Utilized the National Trauma Databank (NTDB) research datasets from 2007-2011.
  • Included patients aged 16 years and older who developed in-hospital complications.
  • Employed forward logistic regression to compare survivors (non-FTR) with those who died (FTR).

Main Results:

  • Older age (65-89 years) was the strongest predictor of FTR, with an adjusted odds ratio (AOR) of 6.58.
  • The risk of FTR increased stepwise with age groups: 1.94 (46-65 yrs), 6.78 (66-89 yrs), and 27.58 (≥90 yrs) compared to 16-45 yrs.
  • An increasing number of complications also significantly raised FTR risk, with ≥4 complications yielding an AOR of 2.25.

Conclusions:

  • The risk of failure to rescue significantly increases with both patient age and the number of in-hospital complications.
  • Age is a critical factor in failure to rescue outcomes for trauma patients.
  • Developing targeted strategies to monitor and manage complications in elderly trauma patients is crucial for improving quality of care.