Elderly Trauma Patients Do Well in Non-ICU Wards

Abstract

CORONADO, CA — When elderly patients are appropriately triaged, they can be selectively admitted to non–intensive care wards with acceptable outcomes, results from a single-center study showed. “Trauma centers across the United States are caring for elderly trauma patients with greater frequency,” researchers led by Marc D. Trust, MD, wrote in an abstract presented during a poster session at the annual meeting of the Western Surgical Association. “Previous literature showed improved outcomes in this population from aggressive care and invasive monitoring. This may have led to an increased utilization of intensive care resources for these patients,” they noted. Dr. Trust, a surgery resident at the University of Texas at Austin, and his associates retrospectively reviewed the medical records of 3,682 trauma patients 65 and older who were admitted from 2006 to 2015. They compared demographic data and outcomes between patients admitted to the ICU and those admitted to the surgical ward. The primary endpoint was mortality, while secondary endpoints were transfer to higher level of care and hospital length of stay. The mean age of the 3,682 patients was 76 years; 1,838 (50%) were admitted to the ICU, while the remaining 1,844 (50%) were admitted to the surgical ward. When the researchers compared patients admitted to the ICU with those admitted to the surgical ward, they observed significant differences in mortality (7% vs. 0.82%, respectively), as well as systolic blood pressure on admission (146 vs. 149 mm Hg), pulse (85 vs. 81 beats per minute), Glasgow Coma Scale (14 vs. 15), Injury Severity Score (16 vs. 8), and hospital stay (a mean of 8 vs. 4 days). In addition, fewer than 1% of patients admitted to the surgical ward required transfer to a higher level of care. Doug Brunk is with the San Diego bureau of Frontline Medical News.