Impact of Type and Number of Complications on Mortality in Admitted Elderly Blunt Trauma Patients

• Published in: The Journal of surgical research Vol. 241; pp. 78 - 86
• Main Authors: Naeem, Zaina, McCormack, Jane E., Huang, Emily C., Vosswinkel, James A., Shapiro, Marc J., Zarlasht, Fnu, Jawa, Randeep S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2019
• Subjects: Accidental Falls; Aged; Aged, 80 and over; Complications; Elderly; Failure to rescue; Female; Hospital Mortality; Humans; Injury Severity Score; Male; Registries - statistics & numerical data; Retrospective Studies; Risk Factors; Trauma; Trauma Centers - statistics & numerical data; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - diagnosis; Wounds, Nonpenetrating - mortality; Complications; Failure to rescue; Trauma; Elderly
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2019.03.031

Advanced age and comorbidities are recognized risk factors for adverse outcomes in elderly trauma patients. However, the contribution of the number and type of complications to in-hospital mortality in elderly blunt trauma admissions has not been extensively studied. A retrospective review of the trauma registry at a level 1 trauma center for blunt trauma patients age ≥65 y hospitalized for at least 2 d between 2010 and 2015. There were 2467 admissions, with a median age of 81 y and median injury severity score of 9. The most common mechanism of injury was a low-level fall. Approximately 19.6% of admissions had a complication: 11.1% major complications, 8.6% other complications. The in-hospital mortality rate was significantly different (P < 0.001) among the three groups at 16.1% of major complications group, 7.1% of other, and 2.1% of no complications (P < 0.001). On multivariate logistic regression, each major complication increased the odds for in-hospital mortality by 1.59-fold. Complications are not infrequent in elderly blunt trauma admissions, despite a generally lower energy mechanism of injury. Each major complication is associated with increased odds of mortality. Multifaceted interventions for prevention and mitigation of complications are indicated.