Martine A. Årsland (Stavanger / NO), Cathrine H. Enoksen (Stavanger / NO), Ingvild Dalen (Stavanger / NO), Kjell Egil Tjosevik (Stavanger / NO), Pieter Oord (Stavanger / NO), Clemens Weber (Stavanger / NO), Kenneth Thorsen (Bergen / NO; Stavanger / NO)
Abstract text (incl. references and figure legends)
Introduction
A large group of elderly patients are admitted to hospital after falls, often low energy. Studies show that this group tends to be severely injured and is often undertriaged.
We underwent a closer examination of this group regarding undertriage and mortality.
Material & Methods
We identified patients ≥60 years of age with low energy fall (<1 meter) as traumamechanism, from our trauma registry. The study period was between 01.01.11-31.12.20. Statistical analysis was done using Chi squared test for categorical variables and Mann-Whitney test for continuous variables. All tests are two-sided with statistical significance set to p <0.05. Undertriage was defined as patients with an ISS>15 without trauma team activation (TTA).
Results
In this period we identified 388 patients ≥60 years of age with fall
Median age of the group was 78 years of age, ranging from 61 – 100, of which 53% were males. Location of major injury (LOMI) was head in 41% of the patients, lower extremities in 19% and thorax in 10%.
Thirty day mortality was 9%. Fifty percent were discharged to private home, 31% to nursing home, and the remaining 10% to other hospitals or rehabilitation clinics.
Ninety patients had an ISS >15, 43 of these did not have TTA, i.e. the undertriage rate was 48% (95% confidence interval, 38 to 58%). There were more patients with GCS ≤13 among those with TTA than those without TTA (p<0.001).
In the undertriaged group 23% had GCS ≤13 (7/30).
We found no differences with regard to age, sex, ASA score, etanol, heart rate or respiratory rate.
Conclusions
Geriatric patients with low energy falls with an ISS>15 are undertriaged in half the cases, with GCS ≤13 seen in 1 of 4, mandating increased awareness of this often fragile group.
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