TY - JOUR PY - 2023// TI - The effect of traumatic head injuries on the outcome of middle-aged and geriatric orthopedic trauma patients JO - Injury A1 - Ranson, Rachel A1 - Esper, Garrett W. A1 - Woodruff, Robert A1 - Solasz, Sara J. A1 - Egol, Kenneth A. A1 - Konda, Sanjit R. SP - e111299 EP - e111299 VL - 55 IS - 3 N2 - BACKGROUND: The purpose of this study is to characterize the effects of head injuries amongst the middle-aged and geriatric populations on hospital quality measures, costs, and outcomes in an orthopedic trauma setting.

METHODS: Patients with head and orthopedic injuries aged >55 treated at an academic medical center from October 2014-April 2021 were reviewed for their Abbreviated Injury Score for Head and Neck (AIS-H), baseline demographics, injury characteristics, hospital quality measures and outcomes. Univariate comparative analyses were conducted across AIS-H groups with additional regression analyses controlling for confounding variables. All statistical analyses were conducted with a Bonferroni adjusted alpha.

RESULTS: A total of 1,051 patients were included. The mean age was 74 years, and median AIS-H score was 2 (range 1-6). While outcomes worsened and costs increased as AIS-H scores increased, the most drastic (and clinically relevant) rise occurs between scores 2-3. Patients who sustained a head injury warranting an AIS-H score of 3 experienced a significantly higher rate of major complications, need for ICU admission, inpatient and 1-year mortality with longer lengths of stay and higher total costs despite no differences in demographics or injury characteristics. Regression analysis found a higher AIS-H score was independently associated with greater mortality risk.

CONCLUSION: AIS-H scores >2 correlate with significantly worse outcomes and higher hospital costs. Concomitant head injuries impact both outcomes and direct variable costs for middle-aged and geriatric orthopedic trauma patients. Clinicians, hospitals, and payers should consider the significant effect of head injuries on the hospitalization of these patients.

Language: en

LA - en SN - 0020-1383 UR - http://dx.doi.org/10.1016/j.injury.2023.111299 ID - ref1 ER -