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Emergency medicine (EM) can safely manage geriatric trauma patients sustaining ground level falls: Fostering EM autonomy while safely offloading a busy trauma service

      Highlights

      • Limited data exists regarding triage of geriatric trauma patients (GTPs).
      • Management of ground-level fall (GLF) GTPs by emergency medicine (EM) and trauma is associated with similar risk of mortality.
      • GLF GTPs managed initially by EM had a lower rate of admission compared to those managed initially by trauma.

      Abstract

      Objective

      Limited data exists regarding different specialties care of geriatric (>74 years-old) trauma patients (GTPs). We created a “Tier-III” designation for ground-level fall (GLF) GTPs to be managed by EM, with a trauma consult as needed.

      Materials and methods

      A single-center comparison of PRE (1/1/2013-4/30/2016) versus POST (5/1/2016-11/30/2019) Tier-III GTP GLFs. The primary outcome was mortality. Secondary outcomes included admissions, trauma bay procedures and length of stay (LOS).

      Results

      1,652 patients (314-PRE vs. 1,338-POST) were included. The admission rate was lower in the POST (56.9% vs. 88.9%, p < 0.001) cohort. There were no differences in LOS or trauma bay procedures between cohorts (p > 0.05). On multivariable analysis there was similar associated risk of mortality between groups (p = 0.68).

      Conclusion

      The associated risk of mortality was similar between GLF GTP cohorts managed initially by EM and trauma surgeons, however the admission rate was lower in the POST group suggesting EM management may improve hospital bed utilization.

      Keywords

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