Unseen Burden of Injury: Post-Hospitalization Mortality in Geriatric Trauma Patients

Area of Science:

• Geriatric Trauma Care
• Public Health Outcomes
• Mortality Research

Background:

• Older adults are vulnerable to adverse outcomes following trauma.
• Existing trauma registries lack comprehensive long-term, out-of-hospital mortality data for geriatric patients.

Purpose of the Study:

• To investigate long-term, out-of-hospital mortality in geriatric trauma patients.
• To assess the true burden of trauma on older adults beyond acute care and 30-day follow-up.

Main Methods:

• Utilized Level I Trauma Center registry data linked to the US Social Security Death Index (SSDI).
• Analyzed data from 6,289 blunt trauma patients aged 65 and older (2009-2015).
• Compared demographics, injury mechanisms, treatments, and outcomes using descriptive and univariate statistics.

Main Results:

• 8.0% of geriatric trauma patients died during inpatient care.
• Falls (76%) had a 46.5% long-term mortality rate; motor vehicle crashes (19%) had 27.6%.
• 24.1% of all patients died within one year of trauma, with most deaths occurring post-discharge.

Conclusions:

• Inpatient and 30-day mortality metrics inadequately represent the full impact of trauma on older individuals.
• A significant majority (92%) survived discharge, but nearly a quarter succumbed within the year.
• Discharge disposition significantly impacts long-term survival, with higher mortality in skilled nursing facilities.