Growing trend in older patients with severe injuries: mortality and mechanisms of injury between 1991 and 2010 at an inner city major trauma centre.

BACKGROUND

Elderly patients with major trauma are an increasingly important public health concern. The objective of the study was to describe the long term trend in patients aged 65 years and older with major trauma.

METHODS

A retrospective single centre trauma registry study conducted at an inner city Major Trauma Centre in Sydney. Data on patients aged 65 years or older with major trauma (Injury Severity Score greater than 15) presenting between 1991 and 2010 were extracted from the data registry. Demographic data, mechanism of injury, injury severity scores and outcomes were collected. Study outcomes were proportion of total major trauma volume due to patients aged 65 years and older, in hospital mortality and total beddays occupied per year.

RESULTS

The proportion of major trauma volume due to older patients increased by 4.9% per year currently accounting for a third of major trauma volume. The proportion of major trauma in older patients due to falls has also increased. Standardised mortality rates have declined by 2.2% per year.

CONCLUSION

There has been a disproportionate increase in the proportion of major trauma due to older patients at this institution over the past twenty years. If this trend continues, it is likely to have significant impacts on future hospital and rehabilitation resources.