Prolonged Hospital Stay in Elderly Blunt Colorectal Trauma: A National Trauma Data Bank Analysis

Understanding predictors of prolonged hospitalization in elderly colorectal trauma patients is crucial for resource allocation and prognostic counseling, yet the relative contributions of injury severity, surgical complexity, and patient frailty remain unclear. This study aims to identify factors associated with length of hospital stay in elderly patients with blunt colorectal trauma. This is a retrospective cohort study using the National Trauma Data Bank.

Patients aged ≥65 years with blunt colorectal trauma who survived were included. The primary outcome was hospital length of stay (LOS), analyzed as continuous and binary variables (prolonged vs. normal, defined as ≥75^th percentile). Covariates included age, frailty status, sex, injury severity score (ISS), mechanism of injury, and surgical intervention. Multivariable linear and logistic regression analyses.

Among 287 elderly survivors (median age 72.0 years; 60.3% male), the median LOS was 12.0 days. Frailty distribution: 34.8% nonfrail, 40.1% prefrail, 25.1% frail. Motor vehicle accidents predominated (58.9%); 67.9% underwent surgery. ISS was the strongest predictor of continuous LOS (β =0.46; 95% confidence interval [CI], 0.29-0.63; P < 0.001) and prolonged stay (odds ratio = 1.08; 95% CI, 1.05-1.11; P < 0.001). Major colorectal surgery increased LOS (β = 6.71; 95% CI, 2.76-10.67; P < 0.001). Frailty status showed no significant association with either outcome.

In elderly blunt colorectal trauma survivors, injury severity and surgical complexity were primary determinants of hospital LOS, while frailty status did not independently predict prolonged hospitalization.