Increasing importance of the elderly in a trauma system.

The objectives of the study were to determine age- and sex-related trends in hospitalization after injuries. Statewide hospitalization data from 1980-1999 were evaluated annually by sex and age (0-39, 40-64, 65-99), incidence, mean length of stay (LOS), and disposition. Males 0-39 represented 39.6% of admissions in 1980, but only 20.7% in 1999; females >or=65 are now most frequent. These trends partly reflect population changes, but rates of hospitalization for young men have also declined. For age < 65, LOS has gradually decreased since 1980; for age >or=65, LOS decreased after 1990. However, most elderly patients were formerly discharged home, whereas now most are discharged to skilled nursing facilities (SNF). The proportion of younger patients hospitalized in trauma centers increased significantly, but over age 65 this proportion remained stable. Major changes have occurred in populations served by trauma systems. Preventing injuries in the elderly is increasingly important. Accurate evaluation of cost-effectiveness in the elderly must include outcomes from SNF.