Interhospital transfers in elderly trauma patients

Area of Science:

• Trauma care research
• Geriatric emergency medicine
• Patient transfer protocols

Background:

• Growing elderly population globally.
• Older adults have higher mortality from injuries.
• Elderly trauma patients may experience suboptimal triage and require interhospital transfer.

Purpose of the Study:

• To compare interhospital transfer times for elderly (≥65 years) versus younger (18-64 years) adult trauma patients.
• To evaluate adherence to a quality standard for transfer time (<240 min).

Main Methods:

• Retrospective quality assurance study using trauma registry data (2018-2023).
• Included adult trauma patients (≥18 years) transferred between hospitals.
• Primary outcome: time from primary hospital arrival to trauma center arrival.

Main Results:

• Elderly cohort (n=184) experienced significantly longer median transfer delays (247 min) vs. younger cohort (n=381, 197 min).
• Elderly patients met the <240 min transfer time standard less frequently (49% vs. 68%).
• Elderly cohort had higher injury severity and a 6.35-fold increased risk of 30-day mortality.

Conclusions:

• Elderly trauma patients face significantly longer interhospital transfer delays.
• Lower rates of meeting transfer time quality standards observed in the elderly group.
• Findings underscore the need for optimized trauma care pathways for geriatric patients.