D. C. Patel1, T. Li1, N. K. Dhillon1, N. T. Linaval1, L. Kirillova1, D. R. Margulies1, E. J. Ley1, G. Barmparas1 1Cedars-Sinai Medical Center,Los Angeles, CA, USA
Introduction: Elderly patients are at high risk for mortality following traumatic injury and prevention is of paramount importance. This study’s aim was to identify specific times of the day during which the elderly are more likely to be injured.
Methods: The Los Angeles County TEMIS database was retrospectively reviewed for all pedestrians ≥ 18 years who were struck by vehicles over a 16-year period (2000-2015). Elderly (≥ 65 years) patients were compared to non-elderly (18-64 years) with respect to the time of admission and mortality.
Results: Of 36,358 patients, 4,871 (13%) were elderly. The proportion of elderly pedestrian injuries was highest between 6-11am (average 21%), peaking between 10-11 am (23%). This proportion started to abruptly drop at noon, reaching the lowest levels between 2-3 am (2%). Compared to their non-elderly counterparts, the elderly were more likely to have a Glasgow Coma Scale ≤ 8 (11% vs. 7%, p < 0.01), a systolic blood pressure < 90 mmHg (6% vs. 3%, p < 0.01), and a higher Injury Severity Score (median 9 vs. 5, p < 0.01). Overall mortality was 6%, significantly higher in the elderly (14% vs. 4%, p<0.01). Elderly pedestrians had almost a 7-fold higher adjusted odds for death (AOR: 6.8, p<0.01).
Conclusion: Elderly pedestrians struck by vehicles are more likely to be admitted during the morning hours and their mortality risk is high. Preventative strategies with lower speed limits or high surveillance during morning hours in highly populated areas may result in a decreased incidence of these injuries.
