Mortality Profile of Geriatric Trauma at a Level 1 Trauma Center.

BACKGROUND

The management of geriatric trauma patients is challenging because of the altered physiology and co-existent medical conditions. To study the in-hospital mortality profile of geriatric trauma victims and the parameters associated with the mortality, we conducted this retrospective analysis.

METHODS

In a retrospective review of geriatric trauma admissions (above 60 years) over a 3-year period, we studied the association of age, gender, comorbidities, mechanism of injury (MOI), Glasgow coma score (GCS), injury severity score (ISS), systolic blood pressure, and hemoglobin (Hb) level on admission with hospital mortality. Univariate and Multivariable logistic regression was used to estimate odds and find independent associated parameters. < 0.05 was considered as statistically significant.

RESULTS

Out of 881 patients, 208 (23.6%) patients died in hospital. The most common MOI was fall (53.3%) followed by motor vehicle collision (31.1%) and other mechanisms (14.5%). The in-hospital mortality was significantly higher and adjusted odds ratio (OR) for mortality were higher for male gender (2.11 [1.04-4.26]), higher ISS (6.75 [2.07-21.95] for ISS >30), low GCS (<8) (4.6 [2.35-8.97]), low Hb (<9) (1.68 [0.79-3.55]), hypotension on admission (32.42 [10.89-96.52]) as compared to other groups. Adjusted OR was 3.19 (1.55-6.56); 7.67 (1.10-53.49); 1.13 (0.08-17.12) for co-existent cardiovascular, renal, and hepatic comorbidities, respectively.

CONCLUSION

Male gender, higher ISS, low GCS, low Hb, hypotension on admission, co-existent cardiovascular, renal and hepatic comorbidities are associated with increased mortality in geriatric trauma patients.