The impact of discharging minimally injured trauma patient: Does age play a role in trauma admission?

Jacob Peschman, Todd Neideen, Karen Brasel

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

BACKGROUND: Age is suggested as a triage criteria for transfer to a trauma center, despite poor outcomes after similar injury regardless of trauma center level. The effect of differential triage based on age to a trauma center has not been evaluated. We hypothesized that there would be a difference in the admission rates of geriatric patients compared with the rest of the adult trauma population independent of injury severity. METHODS: Records of 1,970 adult patients evaluated by the trauma team at a Level I trauma center and discharged directly from the emergency department were reviewed. Data abstracted included demographics, injuries, and physiologic information. These data were compared with 3,232 trauma patients admitted over the same time period who had similar information abstracted via record review. χ analysis of the admission rates of geriatric patients was performed, followed by a binomial logistic regression to determine factors that affected the odds of admission. RESULTS: A total of 451 (8.68%) patients were 65 years or older; 62.2% of the total population was admitted. Significantly more geriatric patients (82%) were admitted (χ = 126.24; p < 0.001). Multivariate analysis showed that age, head injury, Injury Severity Score, Glasgow Coma Scale, and initial blood pressure were significant independent factors in predicting hospital admission (p < 0.001). CONCLUSIONS: Age alone is associated with increased odds of being admitted to the hospital, independent of injury severity and other physiologic parameters. This has implications for trauma centers that see a significant proportion of geriatric trauma patients and for trauma systems that must prepare for the "aging of America".

Original languageEnglish (US)
Pages (from-to)1331-1335
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume70
Issue number6
DOIs
StatePublished - Jun 1 2011

Keywords

  • Comorbities in the trauma patient
  • Geriatric trauma
  • Trauma admission criteria

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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