Fabrizio A Fiumedinisi1,2, Felix Amsler1,2, Thomas Gross3,4. 1. Department of Traumatology, Trauma Unit, Cantonal Hospital Aarau, Cantonal Hospital, Tellstr.1, CH-5001, Aarau, Switzerland. 2. Amsler Consulting, Gundeldingerrain 111, CH-4059, Basel, Switzerland. 3. Department of Traumatology, Trauma Unit, Cantonal Hospital Aarau, Cantonal Hospital, Tellstr.1, CH-5001, Aarau, Switzerland. thomas.gross@unibas.ch. 4. Amsler Consulting, Gundeldingerrain 111, CH-4059, Basel, Switzerland. thomas.gross@unibas.ch.
Abstract
PURPOSE: Ongoing demographic changes go hand in hand with an increasing number of elderly injured. Given the conflicting literature we wanted to know how much age per se, apart from other factors, actually explains the outcome for elderly trauma patients. METHODS: Retrospective analysis of prospectively collected data on all significantly injured (new injury severity score, NISS ≥ 8) adult patients treated at a Swiss trauma center between 01.01.2010 and 31.12.2017. The association of age and other demographic, trauma or treatment-related variables on parameters of short-term outcome was examined using uni- and multivariate analyses (mean ± SD; R2; p < 0.05). RESULTS: 2692 consecutive patients (33.4% female; mean age 58.1 ± 21.7; hospital mortality 10.1%) were studied. Detailed analysis of quinquennial age groups demonstrated a significant decline in outcome with regard to mortality or return-to-home rate following hospital discharge after the age of 60 years (p < 0.001). In univariate analysis, age explained 4.6% and the number of years ≥ 60 5.9% of hospital mortality. In multivariate analysis, the investigated demographic, trauma or treatment-related parameters contributed at 36.5% to prediction of mortality, age added another 1.5% and number of years ≥ 60 another 2.1% (R2). CONCLUSION: This monocenter evaluation showed a significant decline in short-term outcome and an increase in hospital resource requirements by the trauma patients investigated after the age of 60 years. Even so, after controlling for demographic, injury and treatment variables, age per se only added less than 2% to the prediction of hospital mortality.
PURPOSE: Ongoing demographic changes go hand in hand with an increasing number of elderly injured. Given the conflicting literature we wanted to know how much age per se, apart from other factors, actually explains the outcome for elderly trauma patients. METHODS: Retrospective analysis of prospectively collected data on all significantly injured (new injury severity score, NISS ≥ 8) adult patients treated at a Swiss trauma center between 01.01.2010 and 31.12.2017. The association of age and other demographic, trauma or treatment-related variables on parameters of short-term outcome was examined using uni- and multivariate analyses (mean ± SD; R2; p < 0.05). RESULTS: 2692 consecutive patients (33.4% female; mean age 58.1 ± 21.7; hospital mortality 10.1%) were studied. Detailed analysis of quinquennial age groups demonstrated a significant decline in outcome with regard to mortality or return-to-home rate following hospital discharge after the age of 60 years (p < 0.001). In univariate analysis, age explained 4.6% and the number of years ≥ 60 5.9% of hospital mortality. In multivariate analysis, the investigated demographic, trauma or treatment-related parameters contributed at 36.5% to prediction of mortality, age added another 1.5% and number of years ≥ 60 another 2.1% (R2). CONCLUSION: This monocenter evaluation showed a significant decline in short-term outcome and an increase in hospital resource requirements by the trauma patients investigated after the age of 60 years. Even so, after controlling for demographic, injury and treatment variables, age per se only added less than 2% to the prediction of hospital mortality.
Authors: Nicholas W Goodmanson; Matthew R Rosengart; Amber E Barnato; Jason L Sperry; Andrew B Peitzman; Gary T Marshall Journal: Surgery Date: 2012-10 Impact factor: 3.982
Authors: Rob de Vries; Inge H F Reininga; Oliver Pieske; Rolf Lefering; Mostafa El Moumni; Klaus Wendt Journal: PLoS One Date: 2018-01-05 Impact factor: 3.240
Authors: Benedikt Johannes Braun; Jörg Holstein; Tobias Fritz; Nils Thomas Veith; Steven Herath; Philipp Mörsdorf; Tim Pohlemann Journal: EFORT Open Rev Date: 2017-03-13