Geriatric trauma, frailty, and ACS trauma center verification level: Are there any correlations with outcomes?

• Published in: Injury 2024-01, Vol.55 (1), p.110972-110972, Article 110972
• Main Authors: El-Qawaqzeh, Khaled, Magnotti, Louis J, Hosseinpour, Hamidreza, Nelson, Adam, Spencer, Audrey L, Anand, Tanya, Bhogadi, Sai Krishna, Alizai, Qaidar, Ditillo, Michael, Joseph, Bellal
• Format: Article
• Language: English
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2023.110972

It remains unclear whether geriatrics benefit from care at higher-level trauma centers (TCs). We aimed to assess the impact of the TC verification level on frail geriatric trauma patients' outcomes. We hypothesized that frail patients cared for at higher-level TCs would have improved outcomes. Patients ≥65 years were identified from the Trauma Quality Improvement Program (TQIP) database (2017-2019). Patients transferred, discharged from emergency department (ED), and those with head abbreviated injury scale >3 were excluded. 11-factor modified frailty index was utilized. Propensity score matching (1:1) was performed. Outcomes included discharge to skilled nursing facility or rehab (SNF/rehab), withdrawal of life-supporting treatment (WLST), mortality, complications, failure-to-rescue, intensive care unit (ICU) admission, hospital length of stay (LOS), and ventilator days. 110,680 patients were matched (Frail:55,340, Non-Frail:55,340). Mean age was 79 (7), 90% presented following falls, and median ISS was 5 [2-9]. Level-I/II TCs had lower rates of discharge to SNF/rehab (52.6% vs. 55.8% vs. 60.9%; p