Citation

Hung KK, Yeung JHH, Cheung CSK, Leung LY, Cheng RCH, Cheung NK, Graham CA. Am. J. Emerg. Med. 2019; 37(3): 450-456.

Affiliation

Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Hong Kong; Accident & Emergency Department, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. Electronic address: cagraham@cuhk.edu.hk.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ajem.2018.06.011

PMID

30041911

Abstract

BACKGROUND: With the aging population, the number of older patients with multiple injuries is increasing. The aim of this study was to understand the patterns and outcomes of older patients admitted to a major trauma centre in Hong Kong from 2006 to 2015, and investigate the performance of the trauma team activation (TTA) criteria for these elderly patients.

METHODS: This was a retrospective cohort study from a university hospital major trauma centre in Hong Kong from 2006 to 2015. Patients aged 55 or above who entered the trauma registry were included. Patients were divided into those aged 55-70, and above 70. To test the performance of the TTA criteria, we defined injured patients with severe outcomes as those having any of the following: death within 30 days; the need for surgery; or the need for intensive care unit (ICU) care.

RESULTS: 2218 patients were included over the 10 year period. The 30-day mortality was 7.5% for aged 55-70 and 17.7% for those aged above 70. The sensitivity of TTA criteria for identifying severe outcomes for those aged 55 or above was 35.6%, with 91.6% specificity. The under-triage rate was 59% for age 55-70, and 69.1% for those aged above 70.

CONCLUSION: There is a need to consider alternative TTA criteria for our geriatric trauma population, and to more clearly define the process and standards of care in Hong Kong.

Copyright © 2017 Elsevier Inc. All rights reserved.

Language: en

Keywords

Accidental falls; Cohort studies; Geriatrics; Hong Kong; Multiple trauma; Outcomes; Traffic accidents; Trauma centres; Trauma severity indices