Typology of trauma in the elderly referred to Shahid Rajaee Trauma Center (Emtiaz)

Introduction: Trauma is the main cause of death and disability in all social age groups; it is also the seventh leading cause of fatality among the elderly. Compared to the youth, the risk of mortality and length of hospital stay are higher in the elderly patients experiencing similar trauma and injury severity. Due to the long recovery process in the elderly patients and so need to much careful care in hospital in this age group, in present study we aimed to identify and compare the length of hospitalization in the elderly.Methods: This was a cross-sectional study conducted on 38435 trauma patients who were referred to Shahid Rajaee (Emtiaz) hospital trauma referral center, Shiraz, Iran in 2016. Information such as age, gender, injured body region, length of hospital stay, injury severity score, injury mechanism, length of hospitalization and mortality were recorded. Injury severity scores and injured body regions were determined based on a conversion of international classification of diseases, tenth revision (ICD-10) injury codes to Abbreviated Injury Scale (AIS-98) severity codes, using a locally developed electronic algorithm. A Poisson regression model was used to determine the partial effects of independent risk factors on the length of hospitalization.Results: There were 3415 patients aged over 65 that were about 9% of the total dataset. Their mean age was 75.25-7.71 for the elderly patients (65 and over). Lower extremities (20.56%) and head injuries (41.7%) were the most commonly injured region among them. ISS for 73.47% of them was more than 25, and the most common injury mechanism in them is fall (44.45%). Increasing age and ISS caused 0.03- 0.15% increase in the length of hospitalization stay. Patients who died had stayed in the hospital 2.59 times more than the living patients. Spine and thorax injuries had the highest length of hospitalization compared to other injuries (13.87 and 12.18). Motor accidents the leading cause of the death in older people and most decrease in length of hospitalization. Patients with thorax and spine injuries with 6.81 and 5.71% respectively had longer hospitalization compared to other injuries.Conclusion: According to the results, length of hospitalization was directly related to aging. In addition, gender (males), ISS, and injury area (thorax and spine injuries) were the significant predictors of the length of hospitalization in this age group. Elderly people need care and are more vulnerable to traumatic injury than other age groups.

Keywords:

Elderly , severity of injury , duration of Hospitalization