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Comparison of the epidemiology of elderly trauma between major trauma centres in Riyadh, Saudi Arabia and Melbourne,
Zisis Touloumis1, Sharfuddin M Chowdhury1, Mark C Fitzgerald1
1From the Department of Trauma Surgery (Touloumis, Chowdhury, Aljabri), Trauma Center, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from the Department of Clinical Research (Fitzgerald, Lodge, Ford, Mathew, Groombridge), National Trauma Research Institute, and from the Department of Surgery (Fitzgerald, Lodge, Ford, Mathew, Groombridge), Central Clinical School, Monash University, Melbourne, Australia.
Objectives:
To review the epidemiology of elderly trauma at the Kind Saud Medical City (KSMC), Riyadh, Saudi Arabia, and carry out risk-adjusted analyses to benchmark outcomes with the Alfred Hospital, Melbourne, Australia, the largest Australasian trauma service.
Methods:
This retrospective study included records of injured patients (≥65 years) from the hospital trauma registries during 2022. Demographic and injury data were extracted. Risk-adjusted endpoints were: inpatient mortality and length of stay, analysed using logistic and median regression.
Results:
A total of 193 elderly patients were registered on the KSMC registry and 1233 elderly patients were registered on the Alfred Hospital registry. Kind Saud Medical City saw proportionally less major trauma (injury severity score of >12, 24.4% vs. 44.2%, p<0.001) and less females (31.1% vs 44.4%, p<0.001). The modal injury group was low level falls in both centres (≈60%). Discharge destination was different, particularly for patients discharged home (86.5% vs. 56%) or to a rehabilitation facility (0.5% vs. 28.2%). The risk-adjusted length of stay was 4.5 days less at the Alfred Hospital (95% CI: [3.25-5.77] days, p<0.001). The odds of in-hospital death were not significantly different (OR=0.72, 95% CI: [0.36-1.47], p=0.37).
Conclusion:
Despite the different settings, low level falls were the major cause of injury in older patients. A longer length of stay in the acute hospital was identified for KSMC, however, this may be partly explained by discharge destination practices in the 2 countries.
