NEW ORLEANS — Mortality rates after trauma are three times higher in octogenarians than in septuagenarians, according to an analysis of a trauma registry from a South Carolina hospital presented at the annual meeting of the American Association for the Surgery of Trauma.
Most of the literature suggests that mortality increases with age, but data on trauma outcomes for older patients are limited, said Dr. Robert Palmer of the Greenville (S.C.) Hospital System.
Dr. Palmer and his colleagues aimed to quantify morbidity, mortality, and disposition of cases in patients aged 70–79 and 80–90 years. They reviewed the hospital's trauma registry for the period 2002–2005 and identified 277 patients aged 70–79 and 230 patients over age 80. The group in their 70s represented 7% of all trauma cases, and the over-80 group represented 6% of the cases. Falls accounted for just over half of the trauma in the 70-year-olds and for 80% in the 80-year-olds.
There was no statistically significant difference in the Glasgow Coma Score or Revised Trauma Score (RTS) between the two groups.
There were 16 deaths in the 70s group and 40 in the over-80 group. Head injury was the main cause of death. There was no correlation between the number or types of comorbidities in the two groups and mortality. When mortality was broken down by age and RTS, there were no differences between the groups except for those who had an RTS of 11. Only 11% of the 70- to 79-year-olds died with an RTS of 11, compared with 68% of those over age 80. The fact that some patients had a Do Not Resuscitate order may have changed mortality rates, which were 31% and 42%, respectively, in the 70–79 and over-80 groups with DNR orders.