The results of a new study published in the Journal of the American College of Surgeons reveal that older adults with traumatic injuries may not receive the right level of care. According to the study, a number of elderly patients end up in facilities without specialized expertise in trauma care that can treat all of their injuries. The research team examined data from emergency medical services in Utah and California from 6,015 patients who were injured between January 2006 and December 2007. The patients were ages 55 years and older and were admitted to the hospital.
As indicated on a news release from the American College of Surgeons, the research team subsequently compared information found in patient records, state hospital discharge reports, emergency department records, trauma registry data, and death certificates. The researchers reviewed data from trauma centers that were either designated by local state government health authorities or verified by the ACS COT for the study. The results showed that patients at non-trauma centers had an unadjusted 60-day mortality rate of 9%, while the rate for patients at trauma centers was 5.7%.
In addition, the results revealed that the median hospital stay for patients at trauma centers was also one day shorter than patients at non-trauma centers. The authors of the study also note, "Patients who were taken to non-trauma centers also had fewer interventions performed and fewer major non-orthopedic surgeries." The researchers also examined the patients' injury severity (ISS) scores, and these scores were calculated into one composite score on a scale of 0 to 75.
The researchers considered an ISS score of 15 or higher as a severe injury that required specialized care at a trauma center. The team found that of the 4% of patients with ISS score of 15 or higher, 32.8% should have been taken to trauma center for treatment but were not.
Lead author of the study Kristan L. Staudenmayer, MD, says the next step is to conduct research that examines how elderly patients' health status before they sustain injuries factors into outcomes for patients who don't receive care at a trauma center. Staudenmayer says, "If we're not doing something right, this will continue to cost lives and dollars. When we're able to identify which patients actually benefit from trauma care, we'll see fewer deaths in that subgroup."
Source: American College of Surgeons