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The elderly age criterion for increased in-hospital mortality in trauma patients: a retrospective cohort study

Authors
 Ji Hwan Lee  ;  Min Joung Kim  ;  Ju Young Hong  ;  Jinwoo Myung  ;  Yun Ho Roh  ;  Sung Phil Chung 
Citation
 SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, Vol.29(1) : 133, 2021-09 
Journal Title
SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE
Issue Date
2021-09
MeSH
Adult ; Aged ; Emergency Service, Hospital* ; Hospital Mortality* ; Humans ; Middle Aged ; Odds Ratio ; Registries ; Retrospective Studies ; Trauma Centers ; Wounds and Injuries*
Keywords
Elderly ; Emergency Department-based Injury In-depth Surveillance ; Geriatric ; Injury ; Mortality ; Trauma
Abstract
Background: With an aging population, the number of elderly individuals exposed to traumatic injuries is increasing. The elderly age criterion for traumatic injuries has been inconsistent in the literature. This study aimed at specifying the elderly age criterion when the traumatic mortality rate increases.

Methods: This is a multicenter retrospective cohort study that was conducted utilizing the data from the Emergency Department-based Injury In-depth Surveillance Registry of the Korea Disease Control and Prevention Agency, collected between January 2014 and December 2018 from 23 emergency departments. The outcome variable was in-hospital mortality. Multivariable logistic regression analysis was used to calculate the adjusted mortality rate for each age group. By using the shape-restricted regression splines method, the relationship between age and adjusted traumatic mortality was plotted and the point where the gradient of the graph had the greatest variation was calculated.

Results: A total of 637,491 adult trauma patients were included. The number of in-hospital deaths was 6504 (1.0%). The age at which mortality increased the most was 65.06 years old. The adjusted odds ratio for the in-hospital mortality rate with age in the ≤ 64-year-old subgroup was 1.038 (95% confidence interval (CI) 1.032-1.044) and in the ≥ 65-year-old subgroup was 1.059 (95% CI 1.050-1.068). The adjusted odds ratio for in-hospital mortality in the ≥ 65-year-old compared to the ≤ 64-year-old subgroup was 4.585 (95% CI 4.158-5.055, p < 0.001).

Conclusions: This study found that the in-hospital mortality rate rose with increasing age and that the increase was the most rapid from the age of 65 years. We propose to define the elderly age criterion for traumatic injuries as ≥ 65 years of age.
Files in This Item:
T202104093.pdf Download
DOI
10.1186/s13049-021-00950-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Roh, Yun Ho(노윤호)
Myung, Jinwoo(명진우) ORCID logo https://orcid.org/0000-0002-5125-0881
Lee, Ji Hwan(이지환)
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Hong, Ju Young(홍주영) ORCID logo https://orcid.org/0000-0003-3416-3054
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185427
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