Abstract
BackgroundTraumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage.MethodsPatients eligible for a GC, age ≥ 65, and length of stay > two days, were identified via a chart review from July 2013 to July 2014 at a Level II trauma center. This population was divided into those with and without a GC. Data collected included demographics, injury severity, medications, delirium, mortality, and readmissions. High-risk medications were defined using the Beers Criteria. Statistical analysis involved using appropriate standard tests to compare groups, including multivariate logistic regression.ResultsForty-nine of a total of 104 patients received a GC. Groups were comparable on injury severity score, co-morbidities, and high-risk medication use upon admissions. The GC group was 74% less likely to be discharged on high-risk medications than the non-GC group.ConclusionGC in elderly trauma patients reduces high-risk medication use upon discharge. Further studies are needed to explore how GC impacts readmission rates and mortality. A multidisciplinary trauma team, including a geriatrician, must exist to address the unique medical, psychological, functional, and social issues of a growing, aged trauma population.
Highlights
In 2014, 46 million (15.0%) or about one in every seven individuals were age 65 and older; by 2060, this is expected to more than double to 98 million (1)
The Hackensack University Medical Center (HUMC) department of trauma has developed a protocol based on American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines [2] to determine if geriatricians should be consulted at admission (Figure 1)
Patients were excluded if they did not meet the criteria for a Geriatric consultation (GC), if expected length of stay (LOS) was less than 48 hours, and if patients were in a moribund condition or died in the trauma bay
Summary
In 2014, 46 million (15.0%) or about one in every seven individuals were age 65 and older; by 2060, this is expected to more than double to 98 million (1). Persons age 85 and older are estimated to grow significantly from 6 million in 2014 to 14.6 million in 2040 [1]. With a growing geriatric population, the incidence of traumatic injury will increase [2]. One in three older adults falls each year, leading to direct medical costs totaling $34 billion in 2013 [4]. This cost, along with the total number of falls, is projected to increase significantly as the United States population continues to age [4]. Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. This study aims to determine if receiving a GC had an impact on high-risk medication usage
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