Original Research Article| Volume 223, ISSUE 5, P993-997, May 2022

Long term outcomes in older trauma patients admitted to the ICU: A prospective study

Published:September 07, 2021DOI:


      • Older trauma patients experience high mortality.
      • Older trauma survivors have good health at 6 months.
      • Need for assistance with ambulation associated with higher mortality.



      Prior studies have shown an increase in mortality in elderly patients when compared to their younger cohort.


      Level 1 trauma patients ≥50 years old were recruited upon admission to the ICU and prospectively followed. After an initial survey, inpatient data were collected and phone surveys were completed at 3 and 6 months.


      100 patients were included. There was an 18% inpatient mortality. At 6 months, the mortality rate was 24%; 73% of surviving patients reported good health. 6-month nonsurvivors had a higher percentage requiring preinjury assistance with ambulation.


      Severe trauma in patients ≥50 years of age carries a significant rate of mortality however survivors have good outcomes. Need for assistance with ambulation prior to injury is associated with 6 month mortality and could be used as a screening tool for interventions.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hashmi A.
        • Ibrahim-Zada I.
        • Rhee P.
        • et al.
        Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis.
        J Trauma Acute Care Surg. 2014; 76: 894-901
        • Spaniolas K.
        • Cheng J.D.
        • Gestring M.L.
        • Sangosanya A.
        • Stassen N.A.
        • Bankey P.E.
        Ground level falls are associated with significant mortality in elderly patients.
        J Trauma Inj Infect Crit Care. 2010; 69: 821-825
        • Joseph B.
        • Pandit V.
        • Khalil M.
        • et al.
        Managing older adults with ground-level falls admitted to a trauma service: the effect of frailty.
        J Am Geriatr Soc. 2015; 63: 745-749
        • Joseph B.
        • Pandit V.
        • Rhee P.
        • et al.
        Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer?.
        J Trauma Acute Care Surg. 2014; 76: 196-200
        • Joseph B.
        • Pandit V.
        • Zangbar B.
        • et al.
        Validating trauma-specific frailty Index for geriatric trauma patients: a prospective analysis.
        J Am Coll Surg. 2014; 219 (e1): 10-17
        • Min L.
        • Ubhayakar N.
        • Saliba D.
        • et al.
        The vulnerable Elders survey-13 predicts hospital complications and mortality in older adults with traumatic injury: a pilot study: VES-13 predicts trauma complications.
        J Am Geriatr Soc. 2011; 59: 1471-1476
        • Maxwell C.A.
        • Mion L.C.
        • Mukherjee K.
        • et al.
        Feasibility of screening for preinjury frailty in hospitalized injured older adults.
        J Trauma Acute Care Surg. 2015; 78: 844-851
        • Holcomb J.B.
        • McMullin N.R.
        • Kozar R.A.
        • Lygas M.H.
        • Moore F.A.
        Morbidity from rib fractures increases after age 45.
        J Am Coll Surg. 2003; 196: 549-555
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • Payne J.
        • Gonzalez N.
        • Conde J.G.
        Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inf. 2009; 42: 377-381
        • Harris P.A.
        • Taylor R.
        • Minor B.L.
        • et al.
        The REDCap consortium: building an international community of software platform partners.
        J Biomed Inf. 2019; 95: 103208
      1. NTDB 2016 annual report.
        • Callaway D.W.
        • Shapiro N.I.
        • Donnino M.W.
        • Baker C.
        • Rosen C.L.
        Serum lactate and base deficit as predictors of mortality in normotensive elderly blunt trauma patients.
        J Trauma Inj Infect Crit Care. 2009; 66: 1040-1044
        • Labib N.
        • Nouh T.
        • Winocour S.
        • et al.
        Severely injured geriatric population: morbidity, mortality, and risk factors.
        J Trauma Inj Infect Crit Care. 2011; 71: 1908-1914
        • Calland J.F.
        • Ingraham A.M.
        • Martin N.
        • et al.
        Evaluation and management of geriatric trauma: an Eastern Association for the Surgery of Trauma practice management guideline.
        J Trauma Acute Care Surg. 2012; 73: S345-S350
        • Richmond T.S.
        • Kauder D.
        • Strumpf N.
        • Meredith T.
        Characteristics and outcomes of serious traumatic injury in older adults.
        J Am Geriatr Soc. 2002; 50: 215-222
        • Pickering S.A.W.
        • Esberger D.
        • Moran C.G.
        The outcome following major trauma in the elderly. Predictors of survival.
        Injury. 1999; 30: 703-706
        • Tepas J.J.
        • Veldenz H.C.
        • Lottenberg L.
        • et al.
        Elderly injury: a profile of trauma experience in the sunshine (retirement) state.
        J Trauma Inj Infect Crit Care. 2000; 48: 581-586
        • Saliba D.
        • Elliott M.
        • Rubenstein L.Z.
        • et al.
        The vulnerable Elders survey: a tool for identifying vulnerable older people in the community.
        J Am Geriatr Soc. 2001; 49: 1691-1699
        • Collin C.
        • Wade D.T.
        • Davies S.
        • Horne V.
        The Barthel ADL Index: a reliability study.
        Int Disabil Stud. 1988; 10: 61-63
        • Stalvey B.T.
        • Owsley C.
        • Sloane M.E.
        • Ball K.
        The Life Space questionnaire: a measure of the extent of mobility of older adults.
        J Appl Gerontol. 1999; 18: 460-478
        • Maxwell C.A.
        • Dietrich M.S.
        • Minnick A.F.
        • Mion L.C.
        Preinjury physical function and frailty in injured older adults: self- versus proxy responses.
        J Am Geriatr Soc. 2015; 63: 1443-1447