High risk trauma in older adults in Hong Kong: A multicentre study

Summary Background Trauma is the eighth leading cause of death in Hong Kong. In 2002, 18.5% of the population of Hong Kong was aged 55 years or above, which increased to 22.1% in 2006. The increasing older population in Hong Kong presents a challenge to the health care system yet there is little loc...

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Published in:	Injury Vol. 39; no. 9; pp. 1034 - 1041
Main Authors:	Yeung, Janice H.H, Chang, Annice Ling Mui, Ho, Wendy, So, Fung Ling, Graham, Colin A, Cheng, Beatrice, Cheung, N.K, Ho, H.F, Yuen, W.K, Kam, C.W, Rainer, Timothy H
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-09-2008 Elsevier
Subjects:	Aetiology Aged Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Co-morbidity Diseases of the osteoarticular system Elderly Emergency departments Female General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Glasgow Coma Scale Hong Kong Hong Kong - epidemiology Hospital Mortality Humans Injuries of the limb. Injuries of the spine Injury Injury Severity Score Logistic Models Major trauma Male Medical sciences Middle Aged Older adults Orthopedics Outcome Retrospective Studies Risk Factors Trauma Trauma Centers - statistics & numerical data Traumas. Diseases due to physical agents Wounds and Injuries - classification Wounds and Injuries - epidemiology Wounds and Injuries - etiology Hong Kong Asia China China, People's Rep., Hong Kong British Isles, Scotland, Glasgow Major trauma Emergency departments Hong Kong Injury Outcome Elderly Older adults Trauma Co-morbidity Aetiology Human High risk Prognosis Epidemiology Morbidity Emergency department Etiology Adult Anesthesia
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Summary:	Summary Background Trauma is the eighth leading cause of death in Hong Kong. In 2002, 18.5% of the population of Hong Kong was aged 55 years or above, which increased to 22.1% in 2006. The increasing older population in Hong Kong presents a challenge to the health care system yet there is little local data on older trauma patients. The objectives of this study are firstly to describe the epidemiology of high risk trauma in older patients in Hong Kong, and secondly to identify predictors of trauma mortality. Method Retrospective analysis of prospectively collected data from a centralised trauma database; data collected from 2002 to 2004 from four trauma centres in Hong Kong. Results Between 2002 and 2004, the four trauma centres had a total of 2,124,175 emergency department attendances of which 376,021 (17.7%) were trauma patients, and 80,827 (3.8%) were aged 55 years or older. 810 injured older patients met the inclusion criteria for this study. 380 (46.9%) patients had co-morbidity at the time of injury. Common causes of injury were falls (50.0%, 405/810) and motor vehicle crashes (33.6%, 272/810) of which (77.2%, 210/272) were pedestrians. Mortality was 24.4% (198/810) and increased with advancing age ( p < 0.0001). 53.5% (433/810) of patients had major trauma (ISS > 15). Head injury contributed to 80.3% (159/198) of deaths. 38.4% (311/810) of patients required operations. Most patients were discharged home (40.5%, 328/810) and one-third (270/810) required rehabilitation. Significant predictors of mortality included co-morbidity, injury severity score, age and decreasing Glasgow Coma Score. Conclusion Pedestrians struck by motor vehicles and falls are the principal causes of trauma in older patients in Hong Kong. Mortality increased with advancing age. The independent indicators of trauma mortality in older patients are co-morbidity, age, ISS and GCS.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0020-1383 1879-0267
DOI:	10.1016/j.injury.2008.03.017