Characteristics and Outcomes of Injured Older Adults After Hospital Admission

Authors

  • Leanne M. Aitken RN, PhD,

    1. From the Research Centre for Clinical and Community Practice Innovation, Griffith University, Southport, Queensland, Australia
    2. Princess Alexandra Hospital, Brisbane, Queensland, Australia
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  • Elizabeth Burmeister RN, BN, MSc,

    1. From the Research Centre for Clinical and Community Practice Innovation, Griffith University, Southport, Queensland, Australia
    2. Princess Alexandra Hospital, Brisbane, Queensland, Australia
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  • Jacelle Lang BSc (Hons), MSc,

    1. Queensland Trauma Registry, Centre for National Research on Disability and Rehabilitation Medicine, University of Queensland, Brisbane, Queensland, Australia; and
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  • Wendy Chaboyer RN, PhD,

    1. From the Research Centre for Clinical and Community Practice Innovation, Griffith University, Southport, Queensland, Australia
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  • Therese S. Richmond PhD, CRNP, FAAN

    1. Division of Biobehavioral and Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Address correspondence to Leanne Aitken, Nursing Practice Development Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland, Australia 4102. E-mail: l.aitken@griffith.edu.au

Abstract

OBJECTIVES: To describe the seriously injured adult population aged 65 and older; compare the differences in injury characteristics and outcomes in three subgroups aged 65 to 74, 75 to 84, and 85 and older; and identify predictors of death, complications, and hospital discharge destination.

DESIGN: Retrospective secondary analysis of data from the Queensland Trauma Registry (QTR) using all patients aged 65 and older admitted from 2003 through 2006.

SETTING: Data from 15 regional and tertiary hospitals throughout Queensland, Australia.

PARTICIPANTS: Six thousand sixty-nine patients: 2,291 (37.7%) aged 65 to 74, 2,265 (37.3%) aged 75 to 84, and 1,513 (24.9%) aged 85 and older.

MEASUREMENTS: Outcome variables included mortality, complications, and discharge destination (usual residence, rehabilitation, nursing home, convalescence). Predictive factors incorporated demographic details, injury characteristics, and acute care factors.

RESULTS: Hospital survival was 95.0%, with a median length of hospital stay of 8 days (interquartile range 5–15), and 33.8% of cases with a major injury developed a complication. Predictors of death included older age, male sex, admission to the intensive care unit (ICU), greater Injury Severity Score (ISS), injury caused by a fall, and two or more injuries; those who had surgery were less likely to die. Predictors of complications included ICU admission, older age, longer hospital stay, and two or more injuries. Predictors of discharge to a nursing home included older age, greater ISS, longer hospital stay, and injury caused by a fall, among others.

CONCLUSION: Older adults with severe injuries are at risk of poor outcomes. These findings suggest opportunities for improving geriatric trauma care that could lead to better outcomes.

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