Post-trauma mortality increase at age 60: a cut-off for defining elderly?

• Published in: The American journal of surgery
• Main Authors: Campbell-Furtick, Mackenzie, MS, Moore, Billy J., PhD, Overton, Tiffany L., MA, MPH, Phillips, J. Laureano, MS, MPH, Simon, Kaley J., MPH, CPH, Gandhi, Rajesh R., MD, PhD, Duane, Therese M., MD, Shafi, Shahid, MD, MPH
• Format: Journal Article
• Language: English
• Published: 2015
• Subjects: Surgery; age cut-off; Elderly trauma; elderly age; mortality; geriatric trauma
• ISSN: 0002-9610
• DOI: 10.1016/j.amjsurg.2015.12.018

Abstract Background There has been an increasing emphasis on identifying elderly trauma patients. However, definitions based solely on age vary widely, ranging from age 55 to 80 years, hampering optimal trauma management for older patients. The goal of this study is to develop an objective, data-driven definition for “elderly” in trauma care by evaluating mortality risk as a function of age. Methods We conducted a retrospective analysis of 872,861 adult (≥18 years) patients from the National Trauma Data Bank’s National Sample Program from 2003-2010. The primary outcome was risk-adjusted in-hospital mortality determined using multivariate logistic regression. Contribution of age to mortality was investigated through step-wise regression and percent of R2 attributable to age. We searched for straight-line trends in mortality rate at each age using the spline function of Statistical Analysis Software. Results Statistically significant increases in mortality rate were noted at ages 37, 60, and 78. Age was found to contribute 10% to mortality compared to >80% for GCS and ISS combined. Conclusion Our findings suggest using age 60 years as a data-driven definition of “elderly” in trauma.