Comparative Analysis of Profiles and Outcomes for Elderly Patients with or without Reported Abuse

BackgroundOlder adult (OA) abuse affects the health and welfare of people ages 65 and older. Although previous research has shown that OA abuse impacts their well-being, there is limited understanding of the injury profiles and outcomes for OAs with or without reported abuse. This study compared OAs who reported abuse ((+)RA) to those who did not ((-)RA), hypothesizing OAs with (+)RA have increased mortality.MethodsThe 2017-2019 Trauma Quality Improvement Program (TQIP) was queried for all OAs ages 65 and older. The primary outcome was mortality. Bivariate analyses were performed to compare OAs with (+)RA and (-)RA. Separate multivariable analyses were performed to determine if (+)RA was associated with risk of complications or mortality.ResultsOut of 937 465 OAs, 1552 (0.2%) had (+)RA. OAs with (+)RA had increased rates of gunshot wounds (5.7% vs 0.7%, P < .001) and stab wounds (1.9% vs 0.4%, P < .001) compared to (-)RA patients. (+)RA patients also had increased mortality (6.7% vs 4.2%, P < .001), hospital LOS (5 vs 5, P < .001), and more often underwent surgical interventions (19.0% vs 14.3%, P < .001). On multivariable analysis, OAs with (+)RA had an increased associated risk of complications (OR 1.41, CI 1.16-1.71, P < .001) and mortality (OR 1.35, CI 1.06-1.70, P = .012) compared to OAs with (-)RA.DiscussionThis national analysis demonstrated that OAs with (+)RA had increased rates of penetrating trauma, surgical interventions, ventilator days, and death compared to (-)RA patients. Future prospective studies are needed to ascertain if primary prevention efforts can mitigate the increased morbidity and mortality seen in this vulnerable population.