Citation

Velez AM, Frangos SG, Dimaggio CJ, Berry CD, Avraham JB, Bukur M. Am. J. Surg. 2019; ePub(ePub): ePub.

Affiliation

New York University School of Medicine, Department of Surgery, Division of Trauma and Acute Care Surgery, 462 First Avenue, NBV 15 N1, 10016, New York, NY, USA. Electronic address: marko.bukur@nyumc.org.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2019.06.008

PMID

31208625

Abstract

BACKGROUND: Elderly patients with Traumatic Brain Injury (TBI) are frequently transferred to designated Trauma Centers (TC). We hypothesized that TC transfer is associated with improved outcomes.

METHODS: Retrospective study utilizing the National Trauma Databank. Demographics, injury and outcomes data were abstracted. Patients were dichotomized by transfer to a designated level I/II TC vs. not. Multivariate regression was used to derive the adjusted primary outcome, mortality, and secondary outcomes, complications and discharge disposition.

RESULTS: 19,664 patients were included, with a mean age of 78.1 years. 70% were transferred to a level I/II TC. Transferred patients had a higher ISS (12 vs. 10, p < 0.001). Mortality was significantly lower in patients transferred to level I/II TCs (5.6% vs. 6.2%, Adjusted Odds Ratio (AOR) 0.84, p = 0.011), as was the likelihood of discharge to skilled nursing facilities (26.4% vs. 30.2%, AOR 0.80, p < 0.001).

CONCLUSIONS: Elderly patients with mild TBI transferred to level I/II TCs have improved outcomes. Which patients with mild TBI require level I/II TC care should be examined prospectively.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

Elderly; Mortality; Outcomes; Traumatic brain injury; Triage