Association between clinical factors and mortality in older adult trauma patients: A systematic review and meta-analysis

Abstract

Background: This study reviews and meta-analysis factors affecting mortality in older adult trauma patients, addressing previously unidentified heterogeneity and risk burden.

Methods: Databases (PubMed, Embase, Cochrane and Scopus) were searched for studies from January 1, 2000, to April 30, 2024. Inclusion criteria were patients aged ≥65 years with trauma, assessing survival or death outcomes. Two authors independently screened and extracted data using the PRISMA checklist; disagreements were resolved by a third author.

Results: Eighteen retrospective studies were included (425,355 patients), showing an overall mortality rate of 9.6 ​%. Falls were the predominant cause of injury. Demographic mortality risk factors included advanced age, frailty, male sex, and comorbidities (blood/bleeding disorders, liver disease, cancer, kidney disease, and lung disease). Injury risk factors were identified as contributing to the outcome, including low systolic blood pressure, Glasgow Coma Scale, Injury Severity Score, Revised Trauma Score, and surgical intervention.

Conclusion: Trauma significantly elevates the mortality rate in older adults, with advanced age, gender, comorbidities, injury severity, frailty, and surgical intervention being key factors.