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Short-term outcome following significant trauma: increasing age per se has only a relatively low impact

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Ongoing demographic changes go hand in hand with an increasing number of elderly injured. Given the conflicting literature we wanted to know how much age per se, apart from other factors, actually explains the outcome for elderly trauma patients.

Methods

Retrospective analysis of prospectively collected data on all significantly injured (new injury severity score, NISS  ≥ 8) adult patients treated at a Swiss trauma center between 01.01.2010 and 31.12.2017. The association of age and other demographic, trauma or treatment-related variables on parameters of short-term outcome was examined using uni- and multivariate analyses (mean ± SD; R2; p < 0.05).

Results

2692 consecutive patients (33.4% female; mean age 58.1 ± 21.7; hospital mortality 10.1%) were studied. Detailed analysis of quinquennial age groups demonstrated a significant decline in outcome with regard to mortality or return-to-home rate following hospital discharge after the age of 60 years (p < 0.001). In univariate analysis, age explained 4.6% and the number of years ≥ 60 5.9% of hospital mortality. In multivariate analysis, the investigated demographic, trauma or treatment-related parameters contributed at 36.5% to prediction of mortality, age added another 1.5% and number of years  ≥ 60 another 2.1% (R2).

Conclusion

This monocenter evaluation showed a significant decline in short-term outcome and an increase in hospital resource requirements by the trauma patients investigated after the age of 60 years. Even so, after controlling for demographic, injury and treatment variables, age per se only added less than 2% to the prediction of hospital mortality.

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Acknowlegements

The authors would like to thank all hospital collaborators, particularly Ms. F. Maeder and Ms. B. Wordel for the reliable management of data and Ms J. Buchanan for English language editing of the manuscript.

Funding

This study was funded by the Hospital (Kantonsspital Aarau AG).

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Authors and Affiliations

  1. Department of Traumatology, Trauma Unit, Cantonal Hospital Aarau, Cantonal Hospital, Tellstr.1, CH-5001, Aarau, Switzerland

    Fabrizio A. Fiumedinisi, Felix Amsler & Thomas Gross

  2. Amsler Consulting, Gundeldingerrain 111, CH-4059, Basel, Switzerland

    Fabrizio A. Fiumedinisi, Felix Amsler & Thomas Gross

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  1. Fabrizio A. Fiumedinisi
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  2. Felix Amsler
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Correspondence to Thomas Gross.

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All procedures performed in this study involving human participants were ininser accordance with the ethical standards of the institutional and/or national research committee. Furthermore, the 1964 Helsinki declaration and its later amendments and comparable ethical standards were obeyed. There were no animal studies performed by any of the authors.

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Informed consent was obtained following the study protocol approved by the regional ethics committee.

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Fiumedinisi, F.A., Amsler, F. & Gross, T. Short-term outcome following significant trauma: increasing age per se has only a relatively low impact. Eur J Trauma Emerg Surg 47, 1979–1992 (2021). https://doi.org/10.1007/s00068-020-01357-6

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