Comparing Injury Patterns and Outcomes of Elderly Trauma Patients at Hawkes Bay Hospital: A One Year Retrospective Study
Creffier, C., Hawkes Bay Hospital, Hastings, New Zealand Lo, A., Hawkes Bay Hospital, Hastings, New Zealand
Introduction: The number of people over the age of 65 years old is increasing and therefore the incidence of elderly trauma will increase. We hypothesize that those patients ≥65 would have significantly worse outcomes compared to those <65 years old with increased complications.
Aim: The aim was to compare trauma outcomes of those patients ≥65 years old to those <65 years old at Hawkes Bay Hospital.
Method: A retrospective analysis was performed on Hawke’s Bay District Health Board database for all trauma patients who presented with an Injury Severity Score (ISS) score ≥13 between the 1st January 2020 and 31st December 2020. Information was compared between those ages <65 and those ≥65 including basic demographics, mechanism of injury (MOI), co-morbidities, anti-platelets/anticoagulants, length of ICU and hospital stay, complications, readmission rates and 90 day mortality rates.
Results: In total, 103 patients presented to Hawkes Bay Hospital, with 26 aged ≥65 and 77 aged <65. There was a similar ISS score (19.3±7.2 vs 18.4±7.0) and range of ethnicities. Those aged ≥65 had higher rates of co-morbidities (hypertension, diabetes, chronic obstructive pulmonary disease and atrial fibrillation), anti-platelets and anticoagulants, days in ICU, length in hospital, complication rates and 90 day mortality. Those aged <65 had higher rates of smoking and readmission rates. The most common complications for those ≥65 included medication errors, falls, hospital acquired pneumonia and electrolyte disturbances.
Conclusion: Trauma patients in Hawkes Bay Hospital aged ≥65 had increased length of stay in hospital and ICU with increased complication rates. Interventions such as a trauma-geriatrician that reviews all patients ≥65 years old day one post trauma may be useful to prevent complications, reduce hospital length and facilitate discharge.