Elderly trauma mortality in a resource-limited setting: A benchmark for process improvement.

Area of Science:

• Geriatric Trauma
• Public Health
• African Healthcare Systems

Background:

• Global life expectancy is rising, leading to an increasing burden of elderly trauma.
• Sub-Saharan Africa faces rapid growth in its elderly population, exacerbating this challenge.
• Elderly trauma trends in low-income countries like Malawi remain under-examined.

Purpose of the Study:

• To analyze trends in characteristics and outcomes of elderly trauma patients.
• To compare elderly trauma patients with non-elderly counterparts in Malawi.
• To assess changes in elderly trauma mortality over time.

Main Methods:

• Retrospective analysis of adult trauma registry data from Kamuzu Central Hospital (KCH), Malawi (2011-2017).
• Categorization of patients into elderly (≥ 65 years) and non-elderly (18-64 years) groups.
• Bivariate analysis and Poisson regression modeling to assess mortality risk over time.

Main Results:

• Elderly patients constituted 3.0% of adult trauma cases, with falls being the most common injury mechanism.
• Elderly individuals experienced higher rates of fractures, dislocations, and in-hospital mortality (4.8% vs. 2.4%).
• While healthcare resource utilization (transfers, surgeries, length of stay) increased for the elderly, their in-hospital mortality risk did not significantly change over time when adjusted for injury severity.

Conclusions:

• The proportion of elderly trauma patients at KCH is gradually increasing.
• Despite increased healthcare resource utilization, the overall mortality trend for elderly trauma patients has not improved.
• Further interventions are crucial to enhance outcomes for Malawi's growing elderly trauma population.