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The G60 Trauma Center: A Future Consideration?

Marko Bukur, Joshua Simon, Joseph Catino

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    Summary

    Level I trauma centers treating more elderly patients showed better outcomes. Higher volume of geriatric trauma care correlated with fewer complications and lower mortality rates.

    Area of Science:

    • Trauma Surgery
    • Geriatric Medicine
    • Public Health

    Background:

    • The global elderly population is rapidly increasing.
    • Geriatric trauma patients present unique challenges in care and outcomes.
    • Trauma center volume may influence the quality of care for elderly patients.

    Purpose of the Study:

    • To investigate the impact of elderly trauma patient volume on patient outcomes.
    • To compare outcomes between two Level I trauma centers with differing proportions of elderly trauma patients.

    Main Methods:

    • Retrospective review of elderly patients (>60 years) over five years at two Level I trauma centers.
    • Stratification of patients into an elderly trauma center (ETC) and a reference trauma center (TC) based on patient proportion.

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  • Comparison of demographic, clinical characteristics, and primary outcomes including complications, mortality, and failure to rescue.

    • Main Results:

    • The ETC treated a higher proportion of elderly patients (52% vs 30%) and these patients were older with more severe injuries.
    • Despite higher injury severity in the ETC group, overall complications (14.3% vs 21.9%) and failure to rescue rates (1.8% vs 4.0%) were lower.
    • Adjusted analyses showed significantly lower odds of postinjury complications, failure to rescue, and mortality at the ETC.

    Conclusions:

    • Level I trauma centers with a higher volume of elderly trauma patients demonstrate improved outcomes.
    • Increased experience in managing geriatric trauma may lead to better patient care and reduced adverse events.
    • Further research is needed to identify specific factors contributing to these improved outcomes for quality improvement initiatives.