Geriatric trauma patients at one Level 1 trauma center before and after ortho-geriatric co-management (OGC): an 8-year comparison

Objectives Due to the changing demographics, an increase in numbers of geriatric trauma patients has been observed. The aim of this study was to compare medical complexity, comorbidities and outcome in geriatric trauma patients before and after the implementation of OGC.

Methods Inclusion of patients ages 70 and older, Level 1 trauma center: Stratification according admission year into Group Pre: (admission within 01.01.2010 - 31.12.2010) and Group Post (admission between 01.01.2018 and 31.12.2018). Scoring: Charlson Comorbidity Index (CCI), CCI age adjusted, and ASA score. Outcome: Length of stay (LOS), total mortality. Implementation of OGC between 2012 and 2016.

Results and Conclusion Group Pre (n=626), Group Post (n=841). Increase of geriatric trauma admissions: 34.3 %/8y. Patients in Group 2018 significantly older compared to 2010 (p =0.021). LOS decreased significantly in Group 2018 (p =0.011). Patients in Group 2018 had significantly higher CCI (p < 0.001), significantly higher CCI-age adjusted (p < 0.001). Significantly more patients with ASA 1 were in Group 2010 (16 % versus 5.6 %, p < 0.001) and more patients with ASA 3 were in Group 2018 (38.8 % versus 30.4 %, p < 0.001). Mortality rate in both groups was comparable (8.8 % versus 8.9 %, n.s.)

Conclusion Despite increasing medical complexity after the implementation of OGC, the length of stay decreased while the mortality rate remained constant. This development might be due to the result of improved interdisciplinary management between geriatricians and trauma-surgeons.

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Artikel online veröffentlicht:
15. Oktober 2020