What predicts mortality in the elderly patient presenting as a trauma call? A report from a Major Trauma Centre

Purpose: Within the UK there is a continued expansion of the population over the age of 65, this currently accounts for 17.8% of the British population. We review the impact that centralization of Major Trauma has had, as well as analysing for significant predictors of poor outcome.

Method: All patients presenting to Leeds Major Trauma Centre as a ‘Major Trauma’ who were equal to or over the age of 65 were included in this study. Prospectively collected data from the Trauma Audit Research Network (TARN) was collated to include the above data set from the 1st April 2012 – 1st April 2016. The 1st April 2012 represents the commencement of the Major Trauma Network within Yorkshire. To allow more quantative assessment of patients’ co-morbidities, they were coded as per Charlson Co-morbidity Index for analysis.

Results: 1167 patients presented within the above timeframe. Mean age was 79.5 (range 65–103.5). Mean ISS was 14.8 of the entire cohort. Mortality was 12.9% of the entire cohort. The leading mechanisms of injury were from low energy falls <2m–59.89%, Fall >2m–23.05% and Road Traffic Collision – 16.45%.

Conclusion: Mortality rates since the commencement of the Major Trauma Network within this age group have reduced. This is likely secondary to centralization of major trauma. Variables found to be statistically significant with increased mortality were increasing age, head injury, presence of Chronic Lung Disease, presence of metastases, decreased GCS and increased ISS.