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Review
. 2023 Jun;49(3):1271-1277.
doi: 10.1007/s00068-023-02229-5. Epub 2023 Feb 14.

Social admissions in older trauma patients, not just a one night stay

G J J van Aert  1 , D Huijgen  2 , M Faes  3 , P Boele van Hensbroek  2 , P M J Schormans  2 , D I Vos  2
Affiliations
Review

Social admissions in older trauma patients, not just a one night stay

G J J van Aert et al. Eur J Trauma Emerg Surg. 2023 Jun.

Abstract

Purpose: Older trauma patients (65 years or older), who suffer minor or moderate injury for which immediate hospitalization is not strictly indicated, are often admitted to the hospital due to a self-sufficiency problem. Although hospitalization is expensive and associated with risks, little is known about the course of such a social admission. Therefore, the aim of this study was to clarify the course and outcome of social admissions.

Methods: A single centre retrospective cohort study was performed in a level II trauma centre. All hospitalized trauma patients aged 65 or older between 2015 and 2021 with an Abbreviated Injury Scale (AIS) code of 1 or 2 were included. The primary outcome was defined as the number of complications during admission (e.g. pneumonia, urinary tract infection, delirium, decubitus and, in-hospital mortality). Secondary outcomes were missed injury, length of stay, discharge location (home, with homecare or a skilled nursing facility), 30-day hospital return and 1-year mortality.

Results: Out of 2900 older hospitalized trauma patients, 563 (19.4%) were included. Complications occurred in 99 patients (17.6%), eight patients (1.4%) died during admission, and in 17 patients (3.0%) a previously missed injury was found during the admission. The median length of stay was 5 days [IQR 2.00-9.00] and of all independent living patients, 49.1% could be discharged to their homes. After discharge, 4.4% of the patients returned within 30 days and, a total of 17.6% of all patients died within one year after discharge.

Conclusions: One out of five older trauma patients presenting at the emergency department were admitted because of social reasons. Social admissions are lengthy and are accompanied by a considerable amount of complications.

Keywords: Geriatrics; Social admission; Trauma.

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