Geriatric Trauma Patients—Are They Receiving Trauma Center Care?

Trauma associated with acute myocardial infarction in a multi-state hospitalized population

“…The Injury Severity Score (ISS) [30] reflects the more serious outcomes associated with multiple injuries. Since the two measures have been used in trauma centers to predict the probability of death, urgency of treatment and use of resources, both ISS and MAISS were used in the all regression models [31]. MAISS was entered as a categorical variable, the lowest being b0Q and the highest being b6Q.…”

Interhospital Transfer Occurs More Slowly for Elderly Acute Trauma Patients

“…Elderly patients are less likely to be triaged to a trauma center and they are less likely ultimately to be hospitalized at such centers after initial ED evaluation (3)(4)(5)(6)8). Together, this and previous studies pertaining to the related topics of triage and early interhospital transfer of elderly trauma patients suggest that both prehospital and ED personnel too frequently have a non-aggressive approach to the elderly.…”

“…However, several investigators have observed that elderly trauma patients in particular underutilize trauma centers (3)(4)(5)(6). The reasons for this are unclear but perhaps involve perceptions that little can be done to alter outcomes for these patients, inability of triage criteria to recognize seriously injured elderly patients, or even patient preferences.…”

Access to a Canadian provincial integrated trauma system: A population-based cohort study

“…This may be explained by the fact that the Qué bec trauma system was designed for the management of road injuries [32]. The problem of access to TCs for geriatric patients and women has been widely documented [9,33]. This could be explained by the fact that the staff of pre-hospital services and non-designated centres would have more difficulty identifying cases of severe trauma in older than in younger patients (which are more prone to low-impact mechanisms such as falls of own height) and to transfer them to trauma centres [33].…”

“…The problem of access to TCs for geriatric patients and women has been widely documented [9,33]. This could be explained by the fact that the staff of pre-hospital services and non-designated centres would have more difficulty identifying cases of severe trauma in older than in younger patients (which are more prone to low-impact mechanisms such as falls of own height) and to transfer them to trauma centres [33]. The observation that major and critically injured patients in more remote areas had less access to level I and II TCs is consistent with the literature [18,34].…”