Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth
Objective: To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16–64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2019
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/79485 |
| _version_ | 1848764057359745024 |
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| author | Brown, Elizabeth Tohira, Hideo Bailey, P. Fatovich, D. Pereira, Gavin Finn, Judith |
| author_facet | Brown, Elizabeth Tohira, Hideo Bailey, P. Fatovich, D. Pereira, Gavin Finn, Judith |
| author_sort | Brown, Elizabeth |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16–64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in-hospital mortality. Methods: A retrospective cohort study of major trauma patients transported to hospital by St John Ambulance paramedics in Perth, Western Australia, between 1 January 2013 and 31 December 2016. Multivariate logistic regression was used to test the relationship between age and major trauma centre transport. Multivariate logistic regression analysis using inverse probability of treatment weighting was used to determine if major trauma centre transport was associated with in-hospital mortality in older adults. Results: One thousand six hundred and twenty-five patients were included; of these 576 (35%) were ≥65 years. In comparison with younger adults, older adults had more falls as their mechanism of injury (n = 358 [62%] versus n = 102 [10%], P ≤ 0.001) and more major head injuries (n = 472 [82%] versus n = 609 [58%], P ≤ 0.001). Older adults had lower odds (adjusted odds ratio 0.52, 95% confidence interval [CI] 0.35–0.78) of major trauma centre transport and this was associated with 1.7 times the likelihood of in-hospital mortality (95% CI 1.04–2.7). Conclusions: Older adults who were not transported to the trauma centre had an increased odds of in-hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher-risk population to be identified is important. |
| first_indexed | 2025-11-14T11:13:18Z |
| format | Journal Article |
| id | curtin-20.500.11937-79485 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:13:18Z |
| publishDate | 2019 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-794852020-08-05T07:15:38Z Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth Brown, Elizabeth Tohira, Hideo Bailey, P. Fatovich, D. Pereira, Gavin Finn, Judith emergency medical services major trauma older adults prehospital care Objective: To describe the characteristics and outcomes of older adult (≥65 years) major trauma patients in comparison with younger adults (16–64 years). To determine whether older age is associated with a reduced likelihood of transport (directly or indirectly) to a major trauma centre and whether this is associated with in-hospital mortality. Methods: A retrospective cohort study of major trauma patients transported to hospital by St John Ambulance paramedics in Perth, Western Australia, between 1 January 2013 and 31 December 2016. Multivariate logistic regression was used to test the relationship between age and major trauma centre transport. Multivariate logistic regression analysis using inverse probability of treatment weighting was used to determine if major trauma centre transport was associated with in-hospital mortality in older adults. Results: One thousand six hundred and twenty-five patients were included; of these 576 (35%) were ≥65 years. In comparison with younger adults, older adults had more falls as their mechanism of injury (n = 358 [62%] versus n = 102 [10%], P ≤ 0.001) and more major head injuries (n = 472 [82%] versus n = 609 [58%], P ≤ 0.001). Older adults had lower odds (adjusted odds ratio 0.52, 95% confidence interval [CI] 0.35–0.78) of major trauma centre transport and this was associated with 1.7 times the likelihood of in-hospital mortality (95% CI 1.04–2.7). Conclusions: Older adults who were not transported to the trauma centre had an increased odds of in-hospital mortality. However, older age was associated with a significantly reduced likelihood of trauma centre transport. With the aging population, the development of specific prehospital triage criteria to enable the complexities of this higher-risk population to be identified is important. 2019 Journal Article http://hdl.handle.net/20.500.11937/79485 10.1111/1742-6723.13244 eng http://purl.org/au-research/grants/nhmrc/1116453 fulltext |
| spellingShingle | emergency medical services major trauma older adults prehospital care Brown, Elizabeth Tohira, Hideo Bailey, P. Fatovich, D. Pereira, Gavin Finn, Judith Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title | Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title_full | Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title_fullStr | Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title_full_unstemmed | Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title_short | Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth |
| title_sort | older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in perth |
| topic | emergency medical services major trauma older adults prehospital care |
| url | http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/79485 |