The Vulnerable Elders Survey-13 Predicts Hospital Complications and Mortality in Older Adults with Traumatic Injury: A Pilot Study

Authors

  • Lillian Min MD, MSHS,

    1. From the Division of Geriatrics, Medical School, University of Michigan, Ann Arbor, Michigan
    2. Geriatric Research, Education and Clinical Care Center, Department of Veterans Affairs Ann Arbor, Ann Arbor, Michigan
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  • Nitin Ubhayakar MS,

    1. College of Medicine, University of Cincinnati, Cincinnati, Ohio
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  • Debra Saliba MD, MPH,

    1. Geriatric Research, Education and Clinical Care Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California; Departments of
    2. Surgery
    3. Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
    4. Borun Center for Gerontological Research, University of California at Los Angeles/Jewish Homes, Los Angeles, California
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  • Lorraine Kelley-Quon MD,

    1. Surgery
    2. Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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  • Eric Morley MPH,

    1. School of Medicine, University of California at Davis, Davis, California.
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  • Jonathan Hiatt MD,

    1. Surgery
    2. Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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  • Henry Cryer MD, PhD,

    1. Surgery
    2. Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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  • Areti Tillou MD, MSEd

    1. Surgery
    2. Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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Address correspondence to Lillian Min, University of Michigan Medical School, Division of Geriatrics, 300 North Ingalls Building, Ann Arbor, MI 48109. E-mail: lmin@med.umich.edu

Abstract

OBJECTIVES: To determine whether the Vulnerable Elders Survey (VES)-13, a survey based on functional status that has been validated in uninjured older populations, will predict complications and mortality in injured older adults.

DESIGN: Prospective observational pilot study.

SETTING: Level 1 trauma center.

PARTICIPANTS: Sixty-three older adults (≥65) with a traumatic injury who survived and required inpatient care for at least 24 hours.

MEASUREMENTS: Predictor: preinjury VES-13 score (0–10 points, higher=greater risk) obtained by interviewing participants or proxies. Outcomes: composite outcome of one or more medical complications (e.g., aspiration pneumonia, respiratory failure) or death, discharge destination (home, nursing home, death), length of stay, hospital charges. Covariates: Charlson Comorbidity Index (CCI), Injury Severity Score (ISS), and sex.

RESULTS: Of the 63 participants, 30 (48%) were discharged to home and 28 (44%) to a nursing facility, 21 (33%) developed one or more complications, and four (6%) died. In a model that also controlled for ISS and comorbidity, each additional VES-13 point was associated with greater risk of complication or death (odds ratio=1.53 per point, 95% confidence interval=1.12–2.07).

CONCLUSION: The VES-13, in combination with injury severity, may be useful early in the hospital course to predict complications and death in older adults with traumatic injury, potentially identifying candidates who may benefit from additional inpatient geriatric services.

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