Journal article
Predictors of mortality in geriatric trauma patients: A systematic review and meta- analysis
The journal of trauma and acute care surgery, Vol.76(3), pp.894-901
03/01/2014
DOI: 10.1097/TA.0b013e3182ab0763
PMID: 24553567
Abstract
BACKGROUND The rate of mortality and factors predicting worst outcomes in the geriatric population presenting with trauma are not well established. This study aimed to examine mortality rates in severe and extremely severe injured individuals 65 years or older and to identify the predictors of mortality based on available evidence in the literature.
METHODS We performed a systematic literature search on studies reporting mortality and severity of injury in geriatric trauma patients using MEDLINE, PubMed, and Web of Science.
RESULTS An overall mortality rate of 14.8% (95% confidence interval [CI], 9.8-21.7%) in geriatric trauma patients was observed. Increasing age and severity of injury were found to be associated with higher mortality rates in this patient population. Combined odds of dying in those older than 74 years was 1.67 (95% CI, 1.34-2.08) compared with the elderly population aged 65 years to 74 years. However, the odds of dying in patients 85 years and older compared with those of 75 years to 84 years was not different (odds ratio, 1.23; 95% CI, 0.99-1.52). A pooled mortality rate of 26.5% (95% CI, 23.4-29.8%) was observed in the severely injured (Injury Severity Score [ISS] 16) geriatric trauma patients. Compared with those with mild or moderate injury, the odds of mortality in severe and extremely severe injuries were 9.5 (95% CI, 6.3-14.5) and 52.3 (95% CI, 32.0-85.5; p 0.0001), respectively. Low systolic blood pressure had a pooled odds of 2.16 (95% CI, 1.59-2.94) for mortality.
CONCLUSION Overall mortality rate among the geriatric population presenting with trauma is higher than among the adult trauma population. Patients older than 74 years experiencing traumatic injuries are at a higher risk for mortality than the younger geriatric group. However, the trauma-related mortality sustains the same rate after the age of 74 years without any further increase. Moreover, severe and extremely severe injuries and low systolic blood pressure at the presentation among geriatric trauma patients are significant risk factors for mortality.
LEVEL OF EVIDENCE Systematic review and meta-analysis, level IV.
Details
- Title: Subtitle
- Predictors of mortality in geriatric trauma patients: A systematic review and meta- analysis
- Creators
- Ammar Hashmi - University of ArizonaIrada Ibrahim-Zada - University of ArizonaPeter Rhee - University of ArizonaHassan Aziz - University of ArizonaMindy J. Fain - University of ArizonaRandall S. Friese - University of ArizonaBellal Joseph - University of Arizona
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.76(3), pp.894-901
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0b013e3182ab0763
- PMID
- 24553567
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 8
- Language
- English
- Date published
- 03/01/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984701647902771
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