Epidemiology of geriatric trauma patients in Norway: A nationwide analysis of Norwegian Trauma Registry data, 2015–2018. A retrospective cohort study

Cuevas-Østrem, Mathias; Røise, Olav; Wisborg, Torben; Jeppesen, Elisabeth

doi:10.1016/j.injury.2020.11.007

Cited by 21 publications

(26 citation statements)

References 42 publications

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“…Large numbers of studies have also reported increasing numbers of falls and especially in patients aged ≥ 65. (10)(11)(12)30) In UK, the proportion of fall injuries < 2 m among severely injured patients increased from 4.7% from 1990 to 39.1% in 2013. (12) Ten-year trends from 2005-2014 in a statewide trauma registry in Oklahoma, USA, found the APC of fall injuries to increase by 4.0% (95% CI: 3.1-4.9%) and the number of fall injuries among patients ≥ 65 more than doubled.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Trier¹,

Fjølner

Raaber

et al. 2021

Preprint

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Background: Trauma causes a considerable economic and societal burden and the trauma patient population and its prognosis changes over time. The aim of this study is to analyze ten-year trends of trauma patients at a major trauma center in Denmark. Methods: 5366 patients aged ≥ 16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at Aarhus University Hospital Trauma Center between January 1, 2010 and December 31, 2019 were included. Descriptive statistics, incidence rate calculation, parametric and non-parametric test were used. An annual percent change with 95% confidence interval was used to estimate trend in mechanism of injuries. Multiple logistic regression with mortality as outcome were adjusted for age, sex and ISS. Results: The median age increased from 37 in 2010 to 49 in 2019 and the proportion of patients aged ≥ 65 doubled. The incidence of minor injuries (ISS 1-15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 0.62 (95% CI: 0.54 to 0.72). Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 1.35 (95% CI: 1.04 to 1.76). The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression showed lower 30-day mortality for all trauma patients with ISS > 0 over the study period when adjusting for age, sex and ISS (Odds ratio: 0.94, 95% CI: 0.90 to 0.99). The 30-day mortality for severely injured patients with ISS > 15 decreased during the study period when adjusting for age, sex and ISS (Odds ratio: 0.92, 95% CI: 0.87 to 0.97). Fall injuries increased with an annual percent change of 4.1% (95% CI: 2.3% to 6.1%). Conclusions: Ten-year trends of trauma patients in Central Denmark Region show an increasing median age, injury severity and number of fall injuries. The 30-day mortality of trauma patients decreased for both minor injuries and severe injuries when adjusting for age, sex and injury severity. Trial registration: Not applicable.

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Section: Mechanism Of Injurymentioning

confidence: 99%

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Trier¹,

Fjølner

Raaber

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Pre‐existing medical conditions such as diabetes mellitus, obesity, heart disease and hypertension are more frequent and contribute to morbidity in elderly trauma patients 19 . In Norway, Cuecas‐Østrem et al studied geriatric trauma patients nationwide from 2015 to 2018 20 . They included adult trauma patients with a New Injury Severity Score (NISS) ≥ 9 and older than 16 years and compared them to patients aged ≥65.…”

Section: Discussionmentioning

confidence: 99%

“…We found a decreasing APC in pedestrian injuries of −4.7% and scooter injuries of −6.0%. Many studies have also reported increasing numbers of falls, especially in patients aged ≥65 10–12,20 . In the UK, the proportion of fall injuries <2 m among severely injured patients increased from 4.7% in 1990 to 39.1% in 2013 12 .…”

Section: Discussionmentioning

confidence: 99%

“…studied geriatric trauma patients nationwide from 2015 to 2018. 20 They included adult trauma patients with a New Injury Severity Score (NISS) ≥ 9 and older than 16 years and compared them to patients aged ≥65. Geriatric trauma patients in that study had a 30-day mortality of 13.6% compared to 2.6% of patients aged from 16 to 64 years.…”

Section: Changing Demographicsmentioning

confidence: 99%

“…Many studies have also reported increasing numbers of falls, especially in patients aged ≥65. [10][11][12]20 In the UK, the proportion of fall injuries <2 m among severely injured patients increased from 4.7% in 1990 to 39.1% in 2013. 12 Ten-year trends from 2005 to 2014 in a statewide trauma registry in Oklahoma, USA, found the APC of fall injuries to increase by 4.0% (95% CI: 3.1%-4.9%), and the number of fall injuries among patients ≥65 more than doubled.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

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Ten‐year trends of adult trauma patients in Central Denmark Region from 2010 to 2019: A retrospective cohort study

Trier

Fjølner

Sørensen

et al. 2022

Acta Anaesthesiol Scand

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Background Trauma causes significant economic and societal burdens, and the trauma patient population and their prognosis change over time. This study aims to analyze 10‐year trends of trauma patients at a major trauma center in Central Denmark Region. Methods Five thousand three hundred and sixty‐six patients aged ≥16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at a major trauma center between January 1, 2010, and December 31, 2019, were included. An annual percent change with a 95% confidence interval was used to estimate trends in the mechanism of injuries. Multiple logistic regression with mortality as the outcome was adjusted for age, sex, and ISS. Admission year was used as continuous variable in logistic regressions. Results The median age increased from 37 in 2010 to 49 in 2019, and the proportion of patients aged ≥65 doubled. The annual incidence of minor injuries (ISS 1–15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019. Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019. The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression indicates lower 30‐day mortality for all trauma patients over the study period when adjusting for age, sex, and ISS (odds ratio: 0.94, 95% CI: 0.90–0.99). The 30‐day mortality for severely injured patients with ISS > 15 seems to decrease during the study period when adjusting for age, sex, and ISS (Odds ratio: 0.92, 95% CI: 0.87–0.97). Fall injuries increased by 4.1% annually (95% CI: 2.3%–6.1%). Conclusions Ten‐year trends of trauma patients at a major trauma center show an increasing median age, injury severity, and number of fall injuries. The 30‐day mortality of trauma patients decreased slightly for both minor injuries and severe injuries when adjusting for age, sex, and injury severity.

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Developing a simple field triage scheme compatible with regional trauma situations and medical systems using machine learning: A nationwide trauma database study

Tanaka,

Tagami,

Kitano

et al. 2024

Hong Kong j. emerg. med.

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Background and ObjectivesTrauma patients' characteristics and prehospital medical systems differ between countries. We aimed to establish a simple field triage scheme for identifying severe injury patients that reflect the regional features of trauma demographics and trauma management systems.MethodsThis was a retrospective cohort study using the Japan Trauma Data Bank (JTDB). The main outcome was all‐cause in‐hospital mortality. Blunt trauma patients ≥18 years of age were enrolled. Thirty‐five parameters (including demographic characteristics, mechanism of injury, vital signs, and abbreviated injury scale 98) were assessed for each patient using a machine learning method. After calculating the feature importance of each variable from the JTDB 2019–2021 dataset, we selected variables and made schemes by including different combinations of variables. The schemes were analyzed using a receiver operating characteristic curve and validated using the JTDB 2004–2018 dataset.ResultsWe analyzed 48,194 subjects in JTDB 2019–2021. Eight variables were selected and schemes calculated and evaluated using 185,728 cases in the JTDB 2004–2018 dataset. The area under the curve of the most accurate and simplest scheme was 0.845. When the cut‐off value was set at 6, the mortality rate of the positive group (i.e., score ≥6) was 31.8%, the undertriage rate was 4.6%, and the overtriage rate was 68.2%.ConclusionsWe established an easy and reliable field triage scheme suited to the Japanese trauma system which comprised disturbance of consciousness, respiratory failure, shock, head injury, chest injury, multiple injury, fall from height, and age.

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Epidemiology of geriatric trauma patients in Norway: A nationwide analysis of Norwegian Trauma Registry data, 2015–2018. A retrospective cohort study

Cited by 21 publications

References 42 publications

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Ten‐year trends of adult trauma patients in Central Denmark Region from 2010 to 2019: A retrospective cohort study

Developing a simple field triage scheme compatible with regional trauma situations and medical systems using machine learning: A nationwide trauma database study

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