Andrea D Hill1, Ruxandra Pinto, Avery B Nathens, Robert A Fowler. 1. From Sunnybrook Research Institute (A.D.H., A.B.N., R.A.F.); Departments of Critical Care (A.D.H., R.A.F., R.P.), and Surgery (A.B.N.), Sunnybrook Health Sciences Centre; Clinical Epidemiology Program (R.A.F., A.B.N.), Institute of Health Policy, Management and Evaluation, and Interdepartmental Division of Critical Care (R.A.F.), and Keenan Research Centre of the Li Ka Shing Knowledge Institute (A.B.N), St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND: We performed a population-based evaluation of age-related trends in severe injury hospitalization across Canada. METHODS: We identified hospitalizations following severe injury (Injury Severity Score [ISS] > 15) between 2002 and 2009 using the Canadian National Trauma Registry. Age-standardized severe injury hospitalization rates were calculated using the direct method referencing the 2006 Canadian population. The annual percent change in hospitalization rates were estimated using negative binomial regression. RESULTS: During the 8-year period, hospitalization rates for severe injury rose by 22% among individuals 65 years or older, compared with 10% among individuals younger than 65 years. Fall-related injuries accounted for 46% of all severe injury hospitalizations and increased by an average of 3% annually, with a twofold higher annual rate of increase among the elderly. Case-fatality rates declined by 10%, with the decline more than threefold higher among younger patients. CONCLUSION: Elderly patients accounted for an increasing proportion of hospitalizations, highlighting important opportunities for injury prevention among this age group. Case-fatality rates, while declining among younger patients, remained stable in the elderly population, suggesting the need for better strategies to manage the complex care needs of these patients. LEVEL OF EVIDENCE: Epidemiologic study, level III.
BACKGROUND: We performed a population-based evaluation of age-related trends in severe injury hospitalization across Canada. METHODS: We identified hospitalizations following severe injury (Injury Severity Score [ISS] > 15) between 2002 and 2009 using the Canadian National Trauma Registry. Age-standardized severe injury hospitalization rates were calculated using the direct method referencing the 2006 Canadian population. The annual percent change in hospitalization rates were estimated using negative binomial regression. RESULTS: During the 8-year period, hospitalization rates for severe injury rose by 22% among individuals 65 years or older, compared with 10% among individuals younger than 65 years. Fall-related injuries accounted for 46% of all severe injury hospitalizations and increased by an average of 3% annually, with a twofold higher annual rate of increase among the elderly. Case-fatality rates declined by 10%, with the decline more than threefold higher among younger patients. CONCLUSION: Elderly patients accounted for an increasing proportion of hospitalizations, highlighting important opportunities for injury prevention among this age group. Case-fatality rates, while declining among younger patients, remained stable in the elderly population, suggesting the need for better strategies to manage the complex care needs of these patients. LEVEL OF EVIDENCE: Epidemiologic study, level III.
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