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Multicenter Study
. 2023 Jan 30;18(1):e0280345.
doi: 10.1371/journal.pone.0280345. eCollection 2023.

Epidemiology, injury pattern and outcome of older trauma patients: A 15-year study of level-I trauma centers

Axel Benhamed  1   2   3   4 , Brice Batomen  1   5 , Valérie Boucher  1 , Krishan Yadav  6 , Éric Mercier  1   2 , Chartelin Jean Isaac  1 , Mélanie Bérubé  1   7 , Francis Bernard  8 , Jean-Marc Chauny  9 , Lynne Moore  10 , Marie Josée Sirois  1 , Karim Tazarourte  3   4 , Amaury Gossiome  1   3 , Marcel Émond  1   2
Affiliations
Multicenter Study

Epidemiology, injury pattern and outcome of older trauma patients: A 15-year study of level-I trauma centers

Axel Benhamed et al. PLoS One. .

Abstract

Background: Older adults have become a significant portion of the trauma population. Exploring their specificities is crucial to better meet their specific needs. The primary objective was to evaluate the temporal changes in the incidence, demographic and trauma characteristics, injury pattern, in-hospital admission, complications, and outcome of older trauma patients.

Methods: A multicenter retrospective cohort study was conducted using the Quebec Trauma Registry. Patients aged ≥16 years admitted to one of the three adult level-I trauma centers between 2003 and 2017 were included. Descriptive analyses and trend-tests were performed to describe temporal changes.

Results: A total of 53,324 patients were included, and 24,822 were aged ≥65 years. The median [IQR] age increased from 57[36-77] to 67[46-82] years, and the proportion of older adults rose from 41.8% in 2003 to 54.1% in 2017. Among those, falls remain the main mechanism (84.7%-88.3%), and the proportion of severe thorax (+8.9%), head (+8.7%), and spine (+5%) injuries significantly increased over time. The proportion of severely injured older patients almost doubled (17.6%-32.3%), yet their mortality decreased (-1.0%). Their average annual bed-days consumption also increased (+15,004 and +1,437 in non-intensive care wards and ICU, respectively).

Conclusions: Since 2014, older adults have represented the majority of admissions in Level-I trauma centers in Québec. Their bed-days consumption has greatly increased, and their injury pattern and severity have deeply evolved, while we showed a decrease in mortality.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Annual trauma admissions over the years.
Fig 2
Fig 2. Evolution of injury mechanisms by age group.
Falls include: fall from own height and fall from higher that own height, MVC: Motor Vehicule Collision.
Fig 3
Fig 3. Proportion of older patients presenting with hip fracture, rib(s) fracture or traumatic brain injury.
TBI: traumatic brain injury.
Fig 4
Fig 4. Evolution of severe trauma patients and their mortality by age group.
ISS: Injury Severity Score.
Fig 5
Fig 5. Absolute number of bed-days over the years.
Fig 6
Fig 6. Evolution of in-hospital complications.
Fig 7
Fig 7. Hospital discharge destinations over the years.
See this image and copyright information in PMC

References

    1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al.. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204–22. doi: 10.1016/S0140-6736(20)30925-9 - DOI - PMC - PubMed
    1. Dinh MM, Roncal S, Byrne CM, Petchell J. Growing trend in older patients with severe injuries: mortality and mechanisms of injury between 1991 and 2010 at an inner city major trauma centre. ANZ J Surg. 2013;83(1–2):65–9. Epub 20120809. doi: 10.1111/j.1445-2197.2012.06180.x . - DOI - PubMed
    1. Kehoe A, Smith JE, Edwards A, Yates D, Lecky F. The changing face of major trauma in the UK. Emerg Med J. 2015;32(12):911–5. doi: 10.1136/emermed-2015-205265 ; PubMed Central PMCID: PMC4717354. - DOI - PMC - PubMed
    1. Jiang L, Zheng Z, Zhang M. The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients. World Journal of Emergency Surgery. 2020;15(1):59. doi: 10.1186/s13017-020-00340-1 - DOI - PMC - PubMed
    1. Statistics Canada CoP, Statistics Canada Catalogue no. 98-400-X2016001. Available from: https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/dt-td/Rp-eng.c....

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