Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis

Geriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be among the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding mort...

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Main Authors: Kai O. Jensen, Maximilian Lempert, Kai Sprengel, Hans P. Simmen, Carina Pothmann, Mathias Schlögl, Heike A. Bischoff-Ferrari, Christian Hierholzer, Hans C. Pape, Valentin Neuhaus
Format: Article
Language:English
Published: MDPI AG 2020-11-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/9/11/3544
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spelling doaj-28071f11fb5a4c259f0115158e4da58a2020-11-25T04:06:40ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-0193544354410.3390/jcm9113544Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair AnalysisKai O. Jensen0Maximilian Lempert1Kai Sprengel2Hans P. Simmen3Carina Pothmann4Mathias Schlögl5Heike A. Bischoff-Ferrari6Christian Hierholzer7Hans C. Pape8Valentin Neuhaus9Department of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandUniversity Clinic for Acute Geriatric Care, City Hospital Waid, 8037 Zurich, SwitzerlandDepartment of Geriatrics and Ageing Research, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Trauma, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandGeriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be among the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding mortality, length-of-stay and complications with a matched pair analysis. We included patients older than 17 years with an Injury Severity Score (ISS) of 16 or more admitted to our level 1 trauma center between January 2008 and December 2015. The cohort was stratified into two groups (age < 70 and ≥ 70 years). One-to-one matching was performed based on gender, ISS, mechanism of injury (penetrating/blunt), Glasgow coma scale (GCS), base excess, and the presence of coagulopathy (international normalized ratio (INR) ≥ 1.4). Outcome was compared using the paired <i>t</i>-test and McNemar-test. A total of 1457 patients were identified. There were 1022 male (70%) and 435 female patients. Three hundred and sixty-four patients (24%) were older than 70 years. Matching resulted in 57 pairs. Mortality as well as length-of-stay were comparable between geriatric and non-geriatric polytraumatized patients. Complication rate (34% vs. 56%, <i>p</i> = 0.031) was significantly higher in geriatric patients. This indicates the possibility of similar outcomes in geriatric polytraumatized patients receiving optimal care.https://www.mdpi.com/2077-0383/9/11/3544outcomegeriatric traumapolytraumamatched pair analysis
collection DOAJ
language English
format Article
sources DOAJ
author Kai O. Jensen
Maximilian Lempert
Kai Sprengel
Hans P. Simmen
Carina Pothmann
Mathias Schlögl
Heike A. Bischoff-Ferrari
Christian Hierholzer
Hans C. Pape
Valentin Neuhaus
spellingShingle Kai O. Jensen
Maximilian Lempert
Kai Sprengel
Hans P. Simmen
Carina Pothmann
Mathias Schlögl
Heike A. Bischoff-Ferrari
Christian Hierholzer
Hans C. Pape
Valentin Neuhaus
Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
Journal of Clinical Medicine
outcome
geriatric trauma
polytrauma
matched pair analysis
author_facet Kai O. Jensen
Maximilian Lempert
Kai Sprengel
Hans P. Simmen
Carina Pothmann
Mathias Schlögl
Heike A. Bischoff-Ferrari
Christian Hierholzer
Hans C. Pape
Valentin Neuhaus
author_sort Kai O. Jensen
title Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
title_short Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
title_full Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
title_fullStr Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
title_full_unstemmed Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis
title_sort is there any difference in the outcome of geriatric and non-geriatric severely injured patients?—a seven-year, retrospective, observational cohort study with matched-pair analysis
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2020-11-01
description Geriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be among the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding mortality, length-of-stay and complications with a matched pair analysis. We included patients older than 17 years with an Injury Severity Score (ISS) of 16 or more admitted to our level 1 trauma center between January 2008 and December 2015. The cohort was stratified into two groups (age < 70 and ≥ 70 years). One-to-one matching was performed based on gender, ISS, mechanism of injury (penetrating/blunt), Glasgow coma scale (GCS), base excess, and the presence of coagulopathy (international normalized ratio (INR) ≥ 1.4). Outcome was compared using the paired <i>t</i>-test and McNemar-test. A total of 1457 patients were identified. There were 1022 male (70%) and 435 female patients. Three hundred and sixty-four patients (24%) were older than 70 years. Matching resulted in 57 pairs. Mortality as well as length-of-stay were comparable between geriatric and non-geriatric polytraumatized patients. Complication rate (34% vs. 56%, <i>p</i> = 0.031) was significantly higher in geriatric patients. This indicates the possibility of similar outcomes in geriatric polytraumatized patients receiving optimal care.
topic outcome
geriatric trauma
polytrauma
matched pair analysis
url https://www.mdpi.com/2077-0383/9/11/3544
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