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Hospital experience with geriatric trauma impacts long-term survival.
Manuel Castillo-Angeles1, Cheryl K Zogg2, Molly P Jarman3
1Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, MA, USA.
American Journal of Surgery
|February 2, 2025
Summary
Higher geriatric trauma proportion (GTP) in hospitals correlates with better long-term survival for older trauma patients. Despite improvements, mortality risk persists for up to a year post-injury.
Area of Science:
- Geriatric Trauma Care
- Health Services Research
- Trauma Surgery Outcomes
Background:
- Geriatric trauma proportion (GTP) is linked to in-hospital mortality in older patients.
- Understanding GTP's effect on long-term survival is crucial for geriatric trauma care.
Purpose of the Study:
- To investigate the association between hospital geriatric trauma proportion (GTP) and long-term survival in older trauma patients.
- To determine if higher GTP influences mortality rates beyond 30 days.
Main Methods:
- Retrospective analysis of Medicare inpatient claims (2014-2015) for geriatric trauma patients in Florida.
- Hospitals categorized into tertiles based on GTP (geriatric trauma patients / total adult trauma volume).
- Multivariable regression analyzed mortality at 30, 90, 180, and 365 days.
Main Results:
- Included 65,763 geriatric trauma patients.
- Patients in the highest GTP tertile showed reduced mortality at 90 days (OR 0.90), 180 days (OR 0.90), and 365 days (OR 0.91) compared to the lowest tertile.
- Significant associations observed for 90, 180, and 365-day mortality.
Conclusions:
- Increased geriatric trauma proportion (GTP) is associated with improved long-term survival outcomes for older trauma patients.
- Mortality risk for geriatric trauma patients remains elevated for up to 12 months post-injury.
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