P. P. Patel1, L. Gryder1, C. McNicoll1, C. Katona1, P. McGrew1, P. Chestovich1, J. Fildes1, D. Kuhls1 1University Of Nevada,Trauma & Critical Care,Las Vegas, NEVADA, USA
Introduction: As the average life expectancy increases, more older adults continue to drive or travel as passengers in motor vehicles. Crashes involving the elderly have worse outcomes compared to younger patients. The purpose of this study is to describe the injury burden, hospital resource utilization (HRU), hospital charges, and disposition incurred by older adult patients after a motor vehicle crash (MVC).
Methods: The Statewide Vehicular Trauma Database was queried for all individuals age ≥65 injured in a MVC from 2005-2014. Patients were stratified by age: 65-74, 75-84, and ≥85. Relevant data include demographics, crash factors, and injury severity score (ISS). Primary outcome was hospital mortality, with secondary outcomes of hospital and ICU length of stay (LOS), hospital charges, and disposition. Analysis was by Chi-squared and Kruskal-Wallis tests, with p<0.05 considered significant.
Results: A total of 2,029 individuals met inclusion criteria. The average age was 75, majority were Caucasian, restrained, and seated in the driver position. Gender distribution was equal. Injury and HRU was significant for a higher average ISS and an increased mean number of hospital and ICU days in the 75-84 age group. Upon nonparametric analysis, the ≥85 group showed significantly increased ISS, hospital and ICU LOS, and hospital charges. Patients ≥85 were also more likely to die or require disposition to a rehab facility or a nursing home after discharge.
Conclusion: This study demonstrates that although the older adult population is considered a high-risk group, there are significant differences in injury burden, outcomes and HRU within this cohort. Older adults had greater injury severity requiring a higher resource utilization while achieving less desirable outcomes. As the number of older adult trauma patients grows, special attention should be placed on those over age 85 to enhance their recovery after a MVC.
