The American Journal of Surgery
Volume 197, Issue 5 , Pages 571-575 , May 2009

The impact of advanced age on trauma triage decisions and outcomes: A statewide analysis

Presented at the 95th Annual Meeting of the North Pacific Surgical Association, Seattle, WA, November 13–14, 2008.

  • Ryan Lehmann, D.O.

      Affiliations

    • Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA
    • Corresponding Author InformationCorresponding author. Tel.: 253-968-2200; fax: 253-968-5900
    • ,
  • Alec Beekley, M.D.

      Affiliations

    • Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA
    • ,
  • Linda Casey, R.N.

      Affiliations

    • Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA
    • ,
  • Ali Salim, M.D.

      Affiliations

    • Division of Trauma and Surgical Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA
    • ,
  • Matthew Martin, M.D.

      Affiliations

    • Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA

Received 13 November 2008 ,Revised 29 December 2008

References 

  1. Tornetta P, Mostafavi H, Riina J, et al. Morbidity and mortality in elderly trauma patients. J Trauma. 1999;46:702–706
  2. Demetriades D, Sava J, Alo K, et al. Old age as a criterion for trauma team activation. J Trauma. 2001;51:754–757
  3. Finelli FC, Jonsson J, Champion HR, Morelli S, Fouty WJ. A case control study for major trauma in geriatric patients. J Trauma. 1989;29:541–548
  4. Hollis S, Lecky F, Yates DW, et al. The effect of pre-existing medical conditions and age on mortality after injury. J Trauma. 2006;61:1255–1260
  5. Knudson MM, Lieberman J, Morris JA, et al. Mortality factors in geriatric blunt trauma patients. Arch Surg. 1994;129:448–453
  6. Morris JA, MacKenzie EJ, Edelstein SL. The effect of preexisting conditions on mortality in trauma patients. JAMA. 1990;263:1942–1946
  7. Perdue PW, Watts DD, Kaufmann CR, et al. Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma. 1998;45:805–810
  8. Phillips S, Rond PC, Kelly SM, et al. The failure of triage criteria to identify geriatric patients with trauma: results from the Florida trauma triage study. J Trauma. 1996;40:278–283
  9. Rogers FB, Osler TM, Shackford SR, et al. A population-based study of geriatric trauma in a rural state. J Trauma. 2001;50:604–611
  10. Taylor MD, Tracy JK, Meyer W, et al. Trauma in the elderly: intensive care unit resource use and outcome. J Trauma. 2002;53:407–414
  11. Victorino GP, Chong TJ, Pal JD. Trauma in the elderly patient. Arch Surg. 2003;138:1093–1098
  12. Scalea TM, Simon HM, Duncan AO, et al. Geriatric blunt multiple trauma: improved survival with early invasive monitoring. J Trauma. 1990;30:129–136
  13. Demetriades D, Karaiskakis M, Velmahos G, et al. Effect on outcome of early intensive management of geriatric trauma patients. Br J Surg. 2002;89:1319–1322
  14. Zimmer-Gembeck MJ, Southard PA, Hedges JR, et al. Triage in an established trauma system. J Trauma. 1995;39:922–928
  15. Morris JA, MacKenzie EJ, Damiano AM, et al. Mortality in trauma patients: the interaction between host factors and severity. J Trauma. 1990;30:1476–1482
  16. Ivascu FA, Howells GA, Junn FS, et al. Rapid warfarin reversal in anticoagulated patients with traumatic intracranial hemorrhage reduces hemorrhage progression and mortality. J Trauma. 2005;59:1131–1139
  17. Pieracci FM, Eachempati SR, Shou J, et al. Use of long-term anticoagulation is associated with traumatic intracranial hemorrhage and subsequent mortality in elderly patients hospitalized after falls: analysis of the New York State administrative database. J Trauma. 2007;63:519–524
  18. Franko J, Kish KJ, O'Connell BG, et al. Advanced age and preinjury warfarin anticoagulation increase the risk of mortality after head trauma. J Trauma. 2006;61:107–110

 This article represents the opinions of the authors only and does not represent the views of the US Department of Defense, the US Department of the Army, or Madigan Army Medical Center.

PII: S0002-9610(09)00175-5

doi: 10.1016/j.amjsurg.2008.12.037

The American Journal of Surgery
Volume 197, Issue 5 , Pages 571-575 , May 2009

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