TY - JOUR
T1 - Survivorship after High-Energy Geriatric Trauma
AU - Gitajn, Ida L.
AU - Castillo, Renan
AU - Breazeale, Stephen
AU - Schoonover, Carrie
AU - Berger, Peter
AU - Huang, Yanjie
AU - O'Hara, Nathan
AU - O'Toole, Robert V.
AU - Sciadini, Marcus F.
N1 - Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - 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.
AB - 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.
KW - geriatric patients
KW - high-energy trauma
KW - low-energy trauma
KW - mortality
KW - survivorship
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U2 - 10.1097/BOT.0000000000000864
DO - 10.1097/BOT.0000000000000864
M3 - Article
C2 - 28406852
AN - SCOPUS:85017445489
SN - 0890-5339
VL - 31
SP - e230-e235
JO - Journal of orthopaedic trauma
JF - Journal of orthopaedic trauma
IS - 8
ER -