Major trauma in older persons

Beck, Ben; Cameron, Peter; Lowthian, Judy; Fitzgerald, Mark; Judson, Rodney; Gabbe, Belinda

doi:10.1002/bjs5.80

Cited by 69 publications

(79 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study compared the characteristics of major trauma in younger and older patients. Consistent with previous studies of major trauma in older adults, we found that falls from standing were the most common mechanism of injury and as age increased the proportion of falls increased . Similar to a study undertaken in Victoria, we found that with each increasing age group the proportion of patients who received definitive care at a non‐major TC increased .…”

Section: Discussionsupporting

confidence: 89%

“…The primary outcome was transport to the TC and the secondary outcome, in‐hospital mortality. We defined older persons as those aged ≥65 years, which is also in accordance with previous definitions of older persons in trauma studies …”

Section: Methodsmentioning

confidence: 99%

“…Similar to studies conducted elsewhere, we categorised older adults into three groups for comparison: 65–74, 75–84 and 85 years or older …”

Section: Methodsmentioning

confidence: 99%

“…Major trauma has traditionally been viewed as a disease of the young, more specifically, a disease of young males caused by high energy transfer mechanisms of injury . However, in Australia, an increase in the proportion of patients with major trauma aged ≥65 years has been observed, an increase that exceeds rates expected from population growth …”

Section: Introductionmentioning

confidence: 99%

“…As the population is aging, it is important that prehospital care evolves to better understand the needs of older persons following trauma . Therefore, the objectives of this study were to: (i) compare characteristics of older major trauma patients with those of younger patients; (ii) compare characteristics of older adult major trauma patients across three age groups; (iii) determine whether older patients are less likely to be transported to the TC than younger patients (directly or indirectly); and (iv) determine the association between non‐major TC transport and in‐hospital mortality in older adults.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth

Brown

Tohira

Bailey

et al. 2019

Emerg Medicine Australasia

View full text Add to dashboard Cite

Objective To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16–64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in‐hospital mortality. Methods A retrospective cohort study of major trauma patients transported to hospital by St John Ambulance paramedics in Perth, Western Australia, between 1 January 2013 and 31 December 2016. Multivariate logistic regression was used to test the relationship between age and major trauma centre transport. Multivariate logistic regression analysis using inverse probability of treatment weighting was used to determine if major trauma centre transport was associated with in‐hospital mortality in older adults. Results One thousand six hundred and twenty‐five patients were included; of these 576 (35%) were ≥65 years. In comparison with younger adults, older adults had more falls as their mechanism of injury (n = 358 [62%] versus n = 102 [10%], P ≤ 0.001) and more major head injuries (n = 472 [82%] versus n = 609 [58%], P ≤ 0.001). Older adults had lower odds (adjusted odds ratio 0.52, 95% confidence interval [CI] 0.35–0.78) of major trauma centre transport and this was associated with 1.7 times the likelihood of in‐hospital mortality (95% CI 1.04–2.7). Conclusions Older adults who were not transported to the trauma centre had an increased odds of in‐hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher‐risk population to be identified is important.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

“…Similar to studies conducted elsewhere, we categorised older adults into three groups for comparison: 65–74, 75–84 and 85 years or older …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth

Brown

Tohira

Bailey

et al. 2019

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

A health economic analysis of the management of open lower limb fractures in the elderly

Pley

Purohit

Krkovič

et al. 2020

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Aim The aim of this study was to investigate the financial implications of the inpatient management of open lower limb fractures in adults over 65 years old. Further, the study compares the calculated cost to the income received by the hospital for these patients and to the existing body of literature. Methods This study employed direct inpatient costing analysis to estimate the cost of treating the open lower limb fractures incurred by 58 patients over the age of 65 years treated in our centre (Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust) between March 2014 and March 2019. Results The median cost of inpatient care calculated in this study was £20,398 per patient, resulting in a financial loss to the hospital of £5113 per patient. When the results were disaggregated by sex, the median cost for an open lower limb fracture in a male patient was £20,886 compared to £19,304 in a female patient. Data were also disaggregated by the site of injury, which produced a median cost for an open femur fracture of £23,949, and £24,549 and £15,362 for open tibia and ankle fractures, respectively. Conclusion This study provides a valuable estimate of the expense of treating open lower limb fractures in patients over the age of 65 years in a Major Trauma Centre in England. The study highlights the large losses incurred by hospitals in treating these cases, and supports revision of the remuneration structures in the National Health Service to adequately cover their cost.

show abstract