Assessment of Mortality in Older Trauma Patients Sustaining Injuries from Falls or Motor Vehicle Collisions Treated in Regional Level I Trauma Centers

Sampalis, John S.; Nathanson, Robin; Vaillancourt, Julie; Nikolis, Andreas; Liberman, Moïshe; Angelopoulos, John; Krassakopoulos, Nickolaos; Psaradellis, Eliofotisti

doi:10.1097/sla.0b013e31819a8b4f

Cited by 79 publications

(72 citation statements)

References 39 publications

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“…However, there are additional factors affecting outcome in the elderly (such as gender, mechanism of injury, medications) which are not shown to be relevant in younger adults (34,38,39). In addition, some factors influencing mortality in younger adults (for example physiological derangement) may need to be assessed differently in older people (42).…”

Section: Resultsmentioning

confidence: 99%

“…However, in this review injury severity and number of injuries were found to be independent predictors of mortality in older trauma patients (6,36,39). This may be due to the relative inability of older patients to compensate for the stresses of injury, and their propensity for multi-organ failure in response to major trauma (36,48).…”

Section: Injury Related Factorsmentioning

confidence: 99%

“…Sampalis' study, the only one reporting an increased risk of death in older women compared to men, included 4,717 patients, but was restricted to those involved in motor vehicle collisions or those with falls (39). Whether this may have influenced the outcome in this study is uncertain.…”

Section: Demographic Factorsmentioning

confidence: 99%

“…Three of these studies reported an increased risk of death in men, while one (Sampalis, Quebec 2009) reported the opposite (6,34,38,39). Figure 2 shows the Forest plot for the cumulative risk-adjusted mortality for gender, showing a significant increase in mortality in older men compared to older women (cumulative adjusted odds ratio 1.51; 95% CI 1.37 -1.66).…”

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confidence: 99%

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Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Sammy

Lecky

Sutton

et al. 2016

Injury

118

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Section: Resultsmentioning

confidence: 99%

Section: Injury Related Factorsmentioning

confidence: 99%

Section: Demographic Factorsmentioning

confidence: 99%

mentioning

confidence: 99%

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Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Sammy

Lecky

Sutton

et al. 2016

Injury

118

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“…Sampalis et al, compared older falls victims in Canada to those involved in road traffic collisions (RTCs), and found a higher risk&adjusted mortality in those with falls (7), but that study's findings may not be transferable to developing countries. We therefore designed this study to compare older patients with falls to other older trauma patients, in a developing country.…”

Section: Introductionmentioning

confidence: 99%

Are older fallers different? Comparing older fallers and non-fallers in a developing country

Yogi

Sammy

Paul

et al. 2017

Trauma

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Abstract:Objectives Falls are common in older people, causing significant mortality and morbidity but little is known about this phenomenon in developing countries. This study aimed to investigate falls in older people in the developing world, comparing fallers with other trauma patients. Methods We conducted a prospective observational study of older trauma patients in Trinidad over a 4 month period, comparing falls victims with other trauma patients, in relation to their demographic, pre morbid and injury characteristics. Results 439 older trauma patients (aged ≥65 years) were included. Fallers were older (median age 75 years vs 70 years in non fallers). 65.2% of fallers were female, compared to 43.7% of non fallers. Fallers were more likely to suffer from multiple pre existing diseases, with 29.8% having ≥ 3 comordibities, compared to 9.7% of non fallers. Fallers were also more likely to be on multiple medications: 7.1% were on 5 medications, compared to no non fallers. Fallers also sustained more severe injuries and presented with higher acuity than non fallers. Admission and referral rates were higher among fallers compared to other trauma patients (59.9% vs 30.4%). Conclusions Older patients who fall are a distinct group from other older trauma patients, with unique demographic, clinical and injury related characteristics. This information is useful in planning preventive and management strategies for these patients. Abstract ObjectivesFalls are common in older people, causing significant mortality and morbidity but little is known about this phenomenon in developing countries. This study aimed to investigate falls in older people in the developing world, comparing fallers with other trauma patients. MethodsWe conducted a prospective observational study of older trauma patients in Trinidad over a 4 month period, comparing falls victims with other trauma patients, in relation to their demographic, pre&morbid and injury characteristics. of fallers were female, compared to 43.7% of non&fallers. Fallers were more likely to suffer from multiple pre&existing diseases, with 29.8% having ≥ 3 comordibities, compared to 9.7% of non&fallers. Fallers were also more likely to be on multiple medications: 7.1% were on 5 medications, compared to no non&fallers. Fallers also sustained more severe injuries and presented with higher acuity than non&fallers.Admission and referral rates were higher among fallers compared to other trauma patients (59.9% vs 30.4%).

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Major trauma in older persons

et al. 2018

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BackgroundGlobally, populations are ageing, creating challenges for trauma system design. Despite this, little is known about causes of injury and long‐term outcomes in older injured patients. This study aims to describe temporal trends in the incidence, causes and functional outcomes of major trauma in older adults.MethodsThe population‐based Victorian State Trauma Registry was used to identify patients with major trauma aged 65 years and older with a date of injury between 1 January 2007 and 31 December 2016. Temporal trends in population‐based incidence rates were evaluated. Functional outcome was measured using the Glasgow Outcome Scale – Extended.ResultsThere were 9250 older adults with major trauma during the study period. Low falls were the most common mechanism of injury (62·5 per cent), followed by transport‐related events (22·2 per cent) and high falls (9·5 per cent). The number of patients with major trauma aged 65 years and older more than doubled from 2007 to 2016, and the incidence increased by 4·3 per cent per year (incidence rate ratio 1·043, 95 per cent c.i. 1·035 to 1·050; P < 0·001). At 12 months after injury, 41·8 per cent of older adults with major trauma had died, and 52·2 per cent of those who survived to hospital discharge were not living independently.ConclusionsThe number and proportion of older adults with major trauma are increasing rapidly and this will impact on trauma system design. Given the poor long‐term outcomes, there needs to be greater emphasis on ensuring that appropriate interventions are targeted to the right patients and enhanced efforts in primary prevention.

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Assessment of Mortality in Older Trauma Patients Sustaining Injuries from Falls or Motor Vehicle Collisions Treated in Regional Level I Trauma Centers

Abstract: Elderly patients sustaining fall-related injuries and treated at Level I trauma centers are at risk for excess mortality when compared with those injured in MVCs. Effective and efficient methods for treating this population must be determined.

Cited by 79 publications

References 39 publications

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Are older fallers different? Comparing older fallers and non-fallers in a developing country

Major trauma in older persons

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