Electrocardiographic Predictors for Early Risk Stratification: 30-Day Mortality in Older Adult Trauma Patients

Area of Science:

• Geriatric Medicine
• Emergency Medicine
• Cardiology
• Trauma Care

Background:

• Trauma-related fractures in older adults are associated with significant morbidity and mortality.
• Early risk stratification is crucial for managing geriatric trauma patients in the emergency department (ED).
• Electrocardiographic (ECG) findings may offer prognostic insights in this population.

Purpose of the Study:

• To evaluate the prognostic value of admission ECG findings in adult patients with trauma-related fractures.
• To assess the association between ECG abnormalities and 30-day all-cause mortality.
• To identify independent predictors of mortality in this cohort.

Main Methods:

• Prospective observational study enrolling 391 adult patients (≥18 years) with trauma-induced fractures.
• Data collection included demographics, comorbidities, trauma mechanisms, and 12-lead ECG findings at ED admission.
• Logistic regression analysis was employed to determine independent predictors of 30-day mortality.

Main Results:

• Thirty-day mortality was 5.1% (n=20). Non-survivors showed higher frequencies of atrial fibrillation (AF), head trauma, cerebrovascular disease, and polypharmacy.
• Multivariate analysis identified AF (OR: 6.112), head trauma (OR: 16.514), and cerebrovascular disease (OR: 6.725) as independent predictors of 30-day mortality.
• Patients with AF had significantly lower 30-day survival rates (65.0% vs. 96.3%, p=0.001).

Conclusions:

• Electrocardiographic abnormalities, especially AF, are significant predictors of 30-day mortality in older adult trauma patients with fractures.
• The prognostic value of ECG findings is enhanced when considered alongside head trauma and cerebrovascular disease.
• ECG serves as a practical, noninvasive tool for early risk stratification and clinical decision-making in geriatric fracture patients.