Geriatric Trauma - A Rising Tide. Assessing Patient Safety Challenges in a Vulnerable Population Using Norwegian Trauma Registry Data and Focus Group Interviews: Protocol for a Mixed Methods Study.

Mathias Cuevas-Østrem,Torben Wisborg,Olav Røise,Elisabeth Jeppesen

doi:10.2196/15722

Abstract

BackgroundElderly trauma patients constitute a vulnerable group, with a substantial risk of morbidity and mortality even after low-energy falls. As the world’s elderly population continues to increase, the number of elderly trauma patients is expected to increase. Limited data are available about the possible patient safety challenges that elderly trauma patients face. The outcomes and characteristics of the Norwegian geriatric trauma population are not described on a national level.ObjectiveThe aim of this project is to investigate whether patient safety challenges exist for geriatric trauma patients in Norway. An important objective of the study is to identify risk areas that will facilitate further work to safeguard and promote quality and safety in the Norwegian trauma system.MethodsThis is a population-based mixed methods project divided into 4 parts: 3 quantitative retrospective cohort studies and 1 qualitative interview study. The quantitative studies will compare adult (aged 16-64 years) and elderly (aged ≥65 years) trauma patients captured in the Norwegian Trauma Registry (NTR) with a date of injury from January 1, 2015, to December 31, 2018. Descriptive statistics and relevant statistical methods to compare groups will be applied. The qualitative study will comprise focus group interviews with doctors responsible for trauma care, and data will be analyzed using a thematic analysis to identify important themes.ResultsThe project received funding in January 2019 and was approved by the Oslo University Hospital data protection officer (No. 19/16593). Registry data have been extracted for 33,344 patients, and the analysis of these data has begun. Focus group interviews will be conducted from spring 2020. Results from this project are expected to be ready for publication from fall 2020.ConclusionsBy combining data from the NTR with interviews with doctors responsible for treatment and transfer of elderly trauma patients, we will provide increased knowledge about trauma in Norwegian geriatric patients on a national level that will form the basis for further research aiming at developing interventions that hopefully will make the trauma system better equipped to manage the rising tide of geriatric trauma.International Registered Report Identifier (IRRID)PRR1-10.2196/15722

Highlights

IntroductionBackgroundMany high- and middle-income countries around the world face the same demographic changes: people are living longer, birth rates are decreasing, and, elderly people constitute a rapidly growing proportion of the population [1,2]
BackgroundMany high- and middle-income countries around the world face the same demographic changes: people are living longer, birth rates are decreasing, and, elderly people constitute a rapidly growing proportion of the population [1,2]
By combining data from the Norwegian Trauma Registry (NTR) with interviews with doctors responsible for treatment and transfer of elderly trauma patients, we will provide increased knowledge about trauma in Norwegian geriatric patients on a national level that will form the basis for further research aiming at developing interventions that hopefully will make the trauma system better equipped to manage the rising tide of geriatric trauma

Summary

Introduction

BackgroundMany high- and middle-income countries around the world face the same demographic changes: people are living longer, birth rates are decreasing, and, elderly people constitute a rapidly growing proportion of the population [1,2]. Trauma is one of the leading causes of mortality and morbidity worldwide and in all age groups [8,9]. Geriatric trauma patients have higher mortality rates than younger patients, adjusted for the same severity of trauma, and head injury is the leading cause of death [11,12,13]. Risk factors associated with a poor outcome for this group include age, pre-existing medical conditions, anticoagulant use, frailty, and altered physiological response to trauma [14,15,16,17,18,19,20]. Geriatric trauma patients are a vulnerable group. Trauma patients constitute a vulnerable group, with a substantial risk of morbidity and mortality even after low-energy falls. The outcomes and characteristics of the Norwegian geriatric trauma population are not described on a national level

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Discussion

Conclusion