Survivorship after High-Energy Geriatric Trauma

Ida L. Gitajn, Renan Castillo, Stephen Breazeale, Carrie Schoonover, Peter Berger, Yanjie Huang, Nathan O'Hara, Robert V. O'Toole, Marcus F. Sciadini

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate in-hospital, 1-year, and 5-year survivorship of geriatric patients after high-energy trauma, to compare survivorship of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors for mortality. Design: Retrospective. Setting: Urban Level I trauma center. Patients: Study group of 1849 patients with high-energy trauma and comparison group of 761 patients with low-energy trauma. Intervention: Each patient was observed from the time of index admission through the end of the study period or until death or readmission. Main Outcome Measurement: Long-term survivorship based on the Social Security Death Index. Results: Survivorship between patients with high-energy and low-energy injuries was statistically significant. Among patients who sustained high-energy injuries, in-hospital mortality was 8%, 1-year mortality was 15%, and 5-year mortality was 25%. Among patients who sustained low-energy injuries, in-hospital mortality was 3%, 1-year mortality was 23%, and 5-year mortality was 40%. Low-energy mechanism of injury was an independent predictor for 1-year and 5-year mortality, even when controlling for Charlson Comorbidity Index (CCI), Injury Severity Score (ISS), age, sex, body mass index (BMI), and admission Glasgow Coma Scale (GCS) score. Conclusions: Geriatric patients with high-energy injuries and those with low-energy injuries seem to represent different patient populations, and low-energy mechanism seems to be a marker for frailty. High-energy mechanism was associated with lower long-term mortality rates, even when controlling for CCI, ISS, age, sex, BMI and admission GCS score.

Original languageEnglish (US)
Pages (from-to)e230-e235
JournalJournal of orthopaedic trauma
Volume31
Issue number8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Keywords

  • geriatric patients
  • high-energy trauma
  • low-energy trauma
  • mortality
  • survivorship

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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