Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes

Objective: Geriatric admissions to trauma centers have increased, and in 2013, our center integrated geriatrician consultation with the management of admitted patients. Our goal is to describe our experience with increasing geriatric fall volume to help inform organized geriatric trauma programs. Me...

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Main Authors: Sumit Saha BS, Stephen M. DiRusso MD, PhD, Scott Welle DO, FACOS, FACS, Benjamin Lieberman DO, Joel Sender MD, Ridwan Shabsigh MD, FACS, Gerard A. Baltazar DO, FACOS
Format: Article
Language:English
Published: SAGE Publishing 2019-06-01
Series:Gerontology and Geriatric Medicine
Online Access:https://doi.org/10.1177/2333721419858735
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spelling doaj-db8bdf205aa24ab0930ff0e9328c844a2020-11-25T03:19:58ZengSAGE PublishingGerontology and Geriatric Medicine2333-72142019-06-01510.1177/2333721419858735Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient OutcomesSumit Saha BS0Stephen M. DiRusso MD, PhD1Scott Welle DO, FACOS, FACS2Benjamin Lieberman DO3Joel Sender MD4Ridwan Shabsigh MD, FACS5Gerard A. Baltazar DO, FACOS6City University of New York, New York City, NY, USASBH Health System, Bronx, NY, USASBH Health System, Bronx, NY, USANew York Institute of Technology, Old Westbury, NY, USASBH Health System, Bronx, NY, USACornell University, New York, NY, USANew York University Winthrop Hospital, Mineola, NY, USAObjective: Geriatric admissions to trauma centers have increased, and in 2013, our center integrated geriatrician consultation with the management of admitted patients. Our goal is to describe our experience with increasing geriatric fall volume to help inform organized geriatric trauma programs. Method: We retrospectively analyzed admitted trauma patients ≥65 years old, suffering falls from January 1, 2006, to December 31, 2017. We examined descriptive statistics and changes in outcomes after integration. Results: A total of 1,335 geriatric trauma patients were admitted, of which 1,054 (79%) had suffered falls. Falls increased disproportionately (+280%) compared with other mechanisms of injury (+97%). After 2013, patient discharge disposition to skilled nursing facility decreased significantly (–67%, p < .001), with a concomitant increase in safe discharges home with outpatient services. Regression analysis revealed association between integration of geriatrician consultation and outcomes. Discussion: Geriatrician consultation is associated with optimized discharge disposition of trauma patients. We recommend geriatrician consultation for all geriatric trauma activations.https://doi.org/10.1177/2333721419858735
collection DOAJ
language English
format Article
sources DOAJ
author Sumit Saha BS
Stephen M. DiRusso MD, PhD
Scott Welle DO, FACOS, FACS
Benjamin Lieberman DO
Joel Sender MD
Ridwan Shabsigh MD, FACS
Gerard A. Baltazar DO, FACOS
spellingShingle Sumit Saha BS
Stephen M. DiRusso MD, PhD
Scott Welle DO, FACOS, FACS
Benjamin Lieberman DO
Joel Sender MD
Ridwan Shabsigh MD, FACS
Gerard A. Baltazar DO, FACOS
Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
Gerontology and Geriatric Medicine
author_facet Sumit Saha BS
Stephen M. DiRusso MD, PhD
Scott Welle DO, FACOS, FACS
Benjamin Lieberman DO
Joel Sender MD
Ridwan Shabsigh MD, FACS
Gerard A. Baltazar DO, FACOS
author_sort Sumit Saha BS
title Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
title_short Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
title_full Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
title_fullStr Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
title_full_unstemmed Integration of Geriatrician Consultation for Trauma Admissions May Benefit Patient Outcomes
title_sort integration of geriatrician consultation for trauma admissions may benefit patient outcomes
publisher SAGE Publishing
series Gerontology and Geriatric Medicine
issn 2333-7214
publishDate 2019-06-01
description Objective: Geriatric admissions to trauma centers have increased, and in 2013, our center integrated geriatrician consultation with the management of admitted patients. Our goal is to describe our experience with increasing geriatric fall volume to help inform organized geriatric trauma programs. Method: We retrospectively analyzed admitted trauma patients ≥65 years old, suffering falls from January 1, 2006, to December 31, 2017. We examined descriptive statistics and changes in outcomes after integration. Results: A total of 1,335 geriatric trauma patients were admitted, of which 1,054 (79%) had suffered falls. Falls increased disproportionately (+280%) compared with other mechanisms of injury (+97%). After 2013, patient discharge disposition to skilled nursing facility decreased significantly (–67%, p < .001), with a concomitant increase in safe discharges home with outpatient services. Regression analysis revealed association between integration of geriatrician consultation and outcomes. Discussion: Geriatrician consultation is associated with optimized discharge disposition of trauma patients. We recommend geriatrician consultation for all geriatric trauma activations.
url https://doi.org/10.1177/2333721419858735
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