Outcomes and health care resource utilization in super-elderly trauma patients

Background: Few studies have compared the post-injury outcomes of super-elderly patients to elderly patients. Methods: We performed a retrospective analysis of 1320 multi-trauma geriatric patients treated at a level I trauma center from 2003 through 2007. The outcomes of Super-Elderly (≥80 years old; n = 422) and Elderly (60-79 years old; n = 898) patients were compared after adjustment for patient gender, mechanism of injury, Glasgow coma scale, injury severity score, and admission vital signs. Results: Super-elderly patients had significantly higher risk-adjusted in-hospital mortality compared with elderly patients [13.4% versus 7.7%, adjusted odds ratio = 1.94 (95% CI 1.14, 3.31), P = 0.015]. Of patients surviving hospitalization, super-elderly patients experienced shorter intensive care unit and hospital length of stay, but were more likely to require non-routine discharge (AOR 3.78 (2.75, 5.28), P < 0.0005). Super-elderly patients were more likely than elderly patients to die during hospitalization as a result of withdrawal of medical support (9.5% versus 5.5%, P = 0.007). Conclusions: Super-elderly patients have significantly greater risk-adjusted in-hospital mortality rates than elderly patients after injury, and are more likely to require non-routine discharge if they survive such injury.