Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction Traumatic injury is a leading cause of death and disability in adults ≥ 65 years old, but there are few epidemiological studies addressing this issue. The aim of this epidemiological study was to assess how characteristics of blunt traumatic injuries in adults ≥ 65 vary by age.

Methods Using data from the a single-state trauma registry, this retrospective cohort study examined injured patients ≥ 65 admitted to all level I and level II trauma centers in Pennsylvania between 2011 and 2014 (n=38,562). Patients were stratified by age into three subgroups (age 65-74; 75-84; ≥85).  Demographics, injury, and system-level variables were compared across groups using the Kruskal-Wallis test for continuous variables and the Cochran–Armitage test for categorical variables.

Results Female sex (48.6% vs. 58.7% vs. 67.7%), white race (89.1% vs. 92.6% vs. 94.6%), and non-Hispanic ethnicity (97.5% vs. 98.6% vs. 99.4%) increased significantly with age across age groups.  As age increased, the proportion of falls (69.9% vs. 82.1% vs. 90.3%), in-hospital mortality (4.6% vs. 6.2% vs. 6.8%), and proportion of patients arriving to the hospital via ambulance also increased (73.6% vs. 75.8% vs. 81.1%), while mean injury severity (10.3 vs. 10.1 vs. 9.6)  and the proportion of level one trauma alerts (10.6% vs. 8.2% vs. 6.7%) decreased. No trend was seen between age and patient transfer status.  The five most common diagnoses were vertebral fracture, rib fracture, head contusion, open head wound, and intracranial hemorrhage.Conclusions This study highlights several new areas for further exploration such as the decrease in trauma alert level with age, the increase in mortality with age, and the decrease in demographic diversity with age among older adults receiving care at a trauma center. This descriptive study provides a framework for future research on the relationship between age and blunt traumatic injury in older adults.