Vaughn E Nossaman1, Brett E Larsen2, Jody C DiGiacomo3, Zara Manuelyan4, Renee Afram5, Sally Shukry6, Amiee Luan Kang7, Swapna Munnangi8, L D George Angus9. 1. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: vnossama@numc.edu. 2. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: brettlars@gmail.com. 3. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: jdigiac1@numc.edu. 4. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: zara.manuelyan@gmail.com. 5. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: raframk3@gmail.com. 6. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: sshukry@nyit.edu. 7. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: amiee.luan@gmail.com. 8. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: smunnang@numc.edu. 9. Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA. Electronic address: langus@numc.edu.
Abstract
BACKGROUND: Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered. METHODS: 446 older trauma patients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS). RESULTS: CCI and CPS were associated with HLOS in patients <65. In patients aged 45-65, only CPS was associated with HLOS. CPS was inversely associated with in-hospital mortality in patients <65, but not patients aged 45-65. CCI score was not associated with in-hospital mortality in either group. CONCLUSION: Increased CCI and CPS were associated with increased HLOS. In patients over 65, increased CPS was associated with decreased mortality. This could be due to return toward physiologic normalcy in treated patients not seen in their peers with undiagnosed or untreated comorbidities. Published by Elsevier Inc.
BACKGROUND: Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered. METHODS: 446 older traumapatients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS). RESULTS:CCI and CPS were associated with HLOS in patients <65. In patients aged 45-65, only CPS was associated with HLOS. CPS was inversely associated with in-hospital mortality in patients <65, but not patients aged 45-65. CCI score was not associated with in-hospital mortality in either group. CONCLUSION: Increased CCI and CPS were associated with increased HLOS. In patients over 65, increased CPS was associated with decreased mortality. This could be due to return toward physiologic normalcy in treated patients not seen in their peers with undiagnosed or untreated comorbidities. Published by Elsevier Inc.
Entities:
Keywords:
Geriatric trauma; Outcomes; Scoring systems