Document Type : Research articles

Authors

• Mahnaz Yadollahi ¹
• Asieh Mahmoudi ¹
• Mohammadhadi Niakan ¹
• Maryam Fadaei Dashti ²

¹ Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

² Rajaiei Clinical Research Development Unit, Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran

Abstract

Background: Trauma is the main cause of death in all age groups, as well as the 7th leading cause of fatality among the elderly. Compared to the youth, the risk of mortality and length of hospital stay are higher in elderly patients experiencing similar trauma and injury severity. Objectives: The present study aimed to identify the risk factors for mortality in the elderly. Methods: This was a cross-sectional study conducted on 65304 trauma patients who were referred to Shahid Rajaee (Emtiaz) Hos- pital trauma referral center, Shiraz, Iran 2011 - 2016. Information such as age, gender, injured body region, length of hospital stay, injury severity score (ISS), injury mechanism, nosocomial infection, and mortality was recorded. Injury severity scores and injured body regions were determined based on a conversion of international classification of diseases, the 10th revision (ICD-10) injury codes to Abbreviated Injury Scale (AIS-98) severity codes using a domestically developed electronic algorithm. The binary logistic regression was used to determine the partial effects of independent risk factors. Results: Patients over 60 had a mean age of 70.79 ± 8.83. Mortality rates were 4.7% (330) and 1.05% (614) among patients over and under 60, respectively. The most important risk factors for geriatric mortality included age over 75 [OR = 1.91, 95% CI (1.28 - 2.85)], nosocomial infection [OR = 10.56, 95% CI (6.52 - 17.10)], ISS (16 - 24) [OR = 12.51, 95% CI (7.28 - 21.490)], head injury [OR = 13.17, 95% CI (5.83 - 29.77)], and pedestrian accidents [OR = 1.47, 95% CI (1.47 - 1.95)]. Aging led to increased mortality due to nosocomial infection. Among the elderly patients, males had a higher mean injury severity score compared to females. Conclusions: According to our results, mortality rates increased by age in geriatric trauma patients. With similar severity of in- juries, there was a greater risk of mortality for trauma patients with very old age compared to old patients. Aging, gender (males), nosocomial infection, ISS, and head injury were the most significant predictors of mortality in the elderly.

Keywords

• Geriatric
• Injury Severity Score
• Mortality
• Risk Factor
• Trauma