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Triage Among Elderly Trauma Patients

Triage Among Elderly Trauma Patients

Patients with the most severe injuries can be taken to trauma centers that offer immediate specialized resources. However, instead of going to a trauma center, many elderly patients receive care in facilities without specialized expertise in trauma care. Research has shown that elderly patients are frequently undertriaged, but little is known about the associations between triage patterns and outcomes. Analyzing Undertriage In a study published in the Journal of the American College of Surgeons, Kristan L. Staudenmayer, MD, MS, FACS, and colleagues assessed how undertriaging elderly patients affects outcomes and whether they survived an injury 60 days later. This time frame is important because elderly patients often die after leaving the hospital rather than during hospitalization. Using in-hospital mortality can underestimate the true impact of injuries in this population. The study group reviewed data from emergency medical services in California and Utah from 6,015 patients aged 55 and older. There were no significant differences in 60-day mortality between trauma centers and non-trauma centers for patients who were severely injured in both unadjusted and adjusted analyses. Unadjusted 60-day mortality rates were 16% to 17%. Despite the lack of mortality benefit, severely injured elderly patients treated at trauma centers incurred greater costs. After adjusting for patient and injury characteristics, the median costs for patients at trauma centers were approximately 20% higher than at non-trauma centers. “It’s known that elderly patients don’t do as well as the young after injuries, but it’s difficult to argue that this is purely due to undertriage,” says Dr. Staudenmayer.  “In analyzing all deaths in the elderly, we found that mortality was more commonly associated with falls...
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