Using a Validated Middle-Age and Geriatric Risk Tool to Identify Early (<48 Hours) Hospital Mortality and Associated...

Area of Science:

• Geriatric Trauma Care
• Health Economics
• Predictive Analytics in Medicine

Background:

• Middle-aged and geriatric trauma patients represent a vulnerable population with significant healthcare needs.
• Accurate risk stratification is crucial for optimizing resource allocation and patient outcomes in trauma care.
• Understanding the cost implications associated with high-risk trauma patients is essential for healthcare management.

Purpose of the Study:

• To validate a trauma triage score for identifying middle-aged and geriatric patients at high risk of mortality within 48 hours of hospitalization.
• To determine the direct variable costs of hospitalization for this high-risk cohort.
• To assess the utility of the Score for Trauma Triage in Geriatric and Middle-aged patients (STTGMA) score in stratifying mortality risk and cost.

Main Methods:

• A prospective cohort study was conducted at a single Level 1 trauma center.
• Patients aged 55 years and older meeting specific trauma evaluation criteria were enrolled.
• The STTGMA score was calculated using demographic, injury severity, and functional status data. Outcomes included length of stay, inpatient mortality, and hospitalization costs.

Main Results:

• 1470 patients were studied (mean age 72.2 years); 17 died within 48 hours.
• Patients who died within 48 hours had a significantly higher STTGMA score (50.9% vs. 3.3%, P < 0.001), indicating over 50% mean mortality risk.
• The mean daily cost of care for patients who died within 48 hours was substantially higher ($49,367 vs. $3966, P = 0.031).

Conclusions:

• The validated STTGMA score effectively identifies older trauma patients at high risk for early mortality and high hospitalization costs.
• The STTGMA score facilitates stratification of patients based on both mortality risk and cost profile.
• Implementing targeted cost-saving strategies and improving patient outcomes, including end-of-life care, are necessary for value-based care in this cohort.