+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Role of trauma team activation in poor outcomes of elderly patients



Role of trauma team activation in poor outcomes of elderly patients



Journal of Surgical Research 203(1): 95-102



Elderly trauma patients suffer worse outcomes than younger patients. Trauma team activation (TTA) improves outcomes in younger patients. It is unclear whether decreased TTA effectiveness or under-activation in elderly patients could contribute to their poor outcomes. This retrospective registry study examined all adult trauma patients admitted to a level 1 trauma center over 2 y. Analyses tested (1) whether age modifies the effect of TTA on poor outcomes, (2) whether elderly patients with severe injury were less likely to receive TTA than younger patients, and (3) which early variables were associated with poor outcomes among elderly patients who did not receive TTA. The study included 10,033 patients. The adjusted relative risk from TTA for all ages was 0.48 (95% confidence interval (CI) = 0.34-0.68, P < 0.001), and there was no effect modification by age (interaction term P value, 0.171). The adjusted odds ratio for the young was 0.49 (95% CI = 0.26-0.91, P = 0.024) and for the elderly was 0.80 (95% CI = 0.53-1.20, P = 0.282). The adjusted odds ratio for lack of TTA associated with old age was 1.37 (95% CI = 1.12-1.69, P = 0.003). The strongest associations with poor outcomes were seen with low heart rate, low minimum blood pressure, high injury severity score, and high Glasgow coma score. Lack of TTA could contribute to elderly patients' poor outcomes. Clinicians should not be reassured by normal heart rates and should be wary of even transiently lower blood pressures in the elderly. A large cohort study is needed to identify which additional elderly patients could benefit from TTA.

(PDF emailed within 0-6 h: $19.90)

Accession: 058791661

Download citation: RISBibTeXText

PMID: 27338540

DOI: 10.1016/j.jss.2016.01.036


Related references

Implementation of a Trauma Service Activation and Admission Policy for Very Elderly Trauma Patients: Impact on Hospital Efficiency and Patient Outcomes. American Surgeon 82(6): 493-496, 2017

Characteristics and outcomes of patients discharged home from the Emergency Department following trauma team activation. Injury 41(5): 465-469, 2010

An evaluation of patient outcomes comparing trauma activation vs trauma team not activated utilizing TRISS analysis. Journal of Trauma 39(1): 165, 1995

Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register DGU®). Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 22: 52, 2016

An evaluation of patient outcomes comparing trauma team activated versus trauma team not activated using TRISS analysis. Trauma and Injury Severity Score. Journal of Trauma 41(5): 870-3; Discussion 873-5, 1996

Delayed trauma team activation: patient characteristics and outcomes. Journal of Trauma and Acute Care Surgery 73(3): 695-698, 2012

Dynamic properties of human incudostapedial joint-Experimental measurement and finite element modeling. Medical Engineering and Physics 54: 14-21, 2018

Stable pediatric blunt trauma patients: is trauma team activation always necessary?. Journal of Trauma 45(3): 562-564, 1998

Trauma team activation criteria in managing trauma patients at an emergency room in Thailand. European Journal of Trauma and Emergency Surgery 43(1): 53-57, 2016

Intubated Trauma Patients Do Not Require Full Trauma Team Activation when Effectively Triaged. Journal of the American College of Surgeons 222(4): 603-611, 2016

Sustainable Effectiveness of Applying Trauma Team Activation in Managing Trauma Patients in the Emergency Department. Journal of the Medical Association of Thailand 98(9): 847-851, 2015

The advantages of early trauma team activation in the management of major trauma patients who underwent exploratory laparotomy. Annals of Surgical Treatment and Research 87(6): 319-324, 2014

Increased mortality with undertriaged patients in a mature trauma center with an aggressive trauma team activation system. European Journal of Trauma and Emergency Surgery 39(6): 599-603, 2013

Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelines. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 17: 1, 2009

An evaluation of patient outcomes comparing trauma team activated versus trauma team not activated using TRISS analysis. Journal of Trauma 41(5): 870-885, 1996