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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Article info
Publication history
Published online: July 30, 2022
Accepted:
July 20,
2022
Received in revised form:
June 26,
2022
Received:
March 19,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.