Improvement in geriatric trauma outcomes in an evolving trauma system

Area of Science:

• Trauma Surgery
• Geriatric Medicine
• Public Health

Background:

• Elderly trauma patients face higher mortality rates than younger individuals.
• Recent advancements in trauma care at Oslo University Hospital Ulleval (OUHU) have improved outcomes for severely injured patients.
• The impact of these changes on the elderly trauma population required specific investigation.

Purpose of the Study:

• To evaluate the effectiveness of updated trauma treatment protocols on elderly patients.
• To analyze mortality rates and trauma team activation in geriatric trauma patients over time.
• To identify factors influencing outcomes in elderly trauma survivors.

Main Methods:

• Retrospective study of 2628 trauma patients aged 61+ at OUHU (2002-2013).
• Patients stratified by age groups (61-70, 71-80, 81+) and divided into two time periods (2002-2009 and 2010-2013).
• Logistic regression used to identify variables correlated with mortality and trauma team activation.

Main Results:

• Crude mortality decreased from 19% to 13% (p<0.01) between the two periods.
• Trauma team activation rates increased significantly from 53% to 72% (p<0.01).
• Mortality rose with age (10% in 61-70 vs. 26% in 81+), while trauma team activation decreased in older age groups.

Conclusions:

• A dedicated trauma service improves survival and activation rates in geriatric trauma patients.
• While mortality increases with age, it is inversely related to trauma team activation likelihood.
• Consider trauma team activation for all trauma patients over 70 years old.