Older Persons Trauma Data, Can We Do Better?
Presenter: Michael Keane, Heath Quality and Safety Commission
Authors List
Keane, M., Health Quality and Safety Commission, Wellington, New Zealand
Introduction
The number of older adults in the New Zealand Major Trauma Registry (NZTR) is growing substantially, with an 81% annual increase since 2017/18, far outpacing population growth.
Aims
This abstract investigates the rise and explores how the trauma system is providing best care for older adults who experience major trauma.
Methods
This descriptive study examined NZTR cases (injury severity score >12) from 2017/18-2024/25 focusing on injury events, outcomes, processes of care and improvement opportunities for older adults (75 years-of-age and over).
Results
Conclusions
Despite an ongoing increase in major trauma events among older adults, clinical markers of trauma care indicate poorer performance for these patients compared with expected standards.
Older patients are less likely to receive key elements of specialist trauma care despite increasing injury severity. Raising critical questions, are we underperforming in the delivery of trauma care to older adults, or are current trauma performance markers insufficiently tailored to this population? The evidence suggests elements of both.
Keane, M., Health Quality and Safety Commission, Wellington, New Zealand
Introduction
The number of older adults in the New Zealand Major Trauma Registry (NZTR) is growing substantially, with an 81% annual increase since 2017/18, far outpacing population growth.
Aims
This abstract investigates the rise and explores how the trauma system is providing best care for older adults who experience major trauma.
Methods
This descriptive study examined NZTR cases (injury severity score >12) from 2017/18-2024/25 focusing on injury events, outcomes, processes of care and improvement opportunities for older adults (75 years-of-age and over).
Results
- Major trauma events for older adults more than doubled from 295 (2017/18) to 612 (2024/25), including a 25% rise last year across most >75 age groups.
- Population growth (30%) did not account for this increase (incidence rate rising from 96 to 152 per 100,000 population).
- Low falls remain the predominant mechanism, witrh the number increasing 150% over the period.
- Clinical measures of care for older people:
- Definitive care at tertiary facility was 60%, 16% lower than younger adults.
- Trauma call occured in 25% of incidents, 57% lower than younger adults.
- Index CT was <2 hours in 48% or incidents, 30% lower than younger adults.
- Trauma tertiary survey occured in 47% of incidents, 28% lower than younger adults.
- Improvements in standardised mortality are not seen in older adults.
Conclusions
Despite an ongoing increase in major trauma events among older adults, clinical markers of trauma care indicate poorer performance for these patients compared with expected standards.
Older patients are less likely to receive key elements of specialist trauma care despite increasing injury severity. Raising critical questions, are we underperforming in the delivery of trauma care to older adults, or are current trauma performance markers insufficiently tailored to this population? The evidence suggests elements of both.
