The Effect of Increasing Age on Outcomes in Major Trauma: A Retrospective Cohort Study

To investigate the impact of increasing age on clinical outcomes in major trauma patients. Primary outcomes assessed included time to diagnostic imaging, length of hospital stay, and mortality rates both in-hospital and at 30 days post-injury.

A retrospective observational study was conducted involving major trauma patients presenting to a tertiary referral centre over a 6-year period, 2017-2023. The effect of increasing age on triage, investigation and management, and clinical outcomes, including length of stay and mortality, was examined.

Analysis demonstrated that the likelihood of trauma team activation decreased with increasing age, independent of injury severity score. Increasing age was a significant predictor of in-hospital mortality (odds ratio: 1.06, 95% confidence interval: 1.05-1.07). Rates of computed tomography (CT) utilisation were comparable between older and younger cohorts (≥ 65 vs. < 65 years, 94.8% vs. 94.9%); yet, older patients experienced significantly longer median wait times for imaging (130 min [≥ 65] vs. 79 min [< 65]).

Increasing age is associated with decreased trauma team activation rates irrespective of injury severity. Furthermore, older trauma patients exhibit substantially higher mortality rates, with a marked increase observed beyond initial hospital discharge. Age-specific trauma team activation criteria may reduce under-triage and potentially improve outcomes in older patients.