Due to the unique physiology and co-morbidities of injured geriatric patients, specific interventions are needed to improve outcomes. The purpose of this study was to assess the effect of a change in triage criteria for injured geriatric patients evaluated at an ACS Level I trauma center.
As of October 1, 2013, all injured patients ≥ 70 years of age were mandated to have the highest level trauma activation upon emergency department arrival regardless of physiology or mechanism of injury. Patients admitted prior to that date were designated PRE; those admitted after were designated POST. The study period was from October 1, 2011 through April 30, 2015. Data collected included demographics, mechanism of injury, hypotension on admission, comorbidities, Injury Severity Score (ISS), emergency department length of stay (ED LOS), complications, and mortality. Bivariate and multivariable analyses were used to compare outcomes between the study groups (p<0.05 = significant). Chi-square or Fisher's Exact Test was used as appropriate for bivariate analyses of categorical variables; patient ages were compared using the Wilcoxon Rank Sum test.
2,269 patients (mean = 80.63 years; mean ISS = 12.2; PRE 1,271/POST 933) were included in the study. On multivariable analysis, increasing age, higher ISS and hypotension were associated with higher mortality. POST patients were more likely to have an ED LOS ≤ 2 hours (OR 1.614, 95% CI 1.088-2.394) after controlling for hypotension, ISS, and comorbidities. POST mortality was significantly decreased (OR 0.689, 95% CI 0.484-0.979).
Based on age alone, the focused intervention of a higher level of trauma activation decreased ED LOS and mortality in injured geriatric patients.
III - therapeutic/care management.
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 May 2017.
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