Elderly injury: A profile of trauma experience in the sunshine [retirement] state

Objective: By using mandatory discharge data from a state agency, the recor ds of 116,687 patients hospitalized for treatment of injury were evaluated to develop an epidemiologic and demographic profile of this population and to compare outcomes of patients treated in state-designated trauma centers (TC) with those treated in nontrauma centers (NTC). Methods: Injury severity was calculated by using the International Classifi cation Injury Severity Score methodology to compute individual diagnosis su rvival risk ratios from 698,187 reported diagnoses, and then by using these survival risk ratios to determine probability of survival for every patien t. The population was then categorized by age, injury type, treatment facil ity designation, injury severity as indicated by probability of survival, a nd discharge disposition. Incidence of potentially preventable death was co mpared between TC and NTC, as was the effect on outcome of noninjury comorb idity. Results: The average age of this population was 58 +/- 26 years with signif icant skew toward the elderly in NTC (mean age, 62 +/- 26 years). The most commonly encountered injuries likewise reflected the elderly nature of this population. Although 71.3% received care in NTC, the majority of severely injured were treated in TC, Potentially preventable mortality (>0.5) was si gnificantly lower in TC. The effect of noninjury comorbidity on outcome was better managed by TC, both in terms of decreased mortality and in proporti on of patients discharged home. Conclusion: These data demonstrate the unique characteristics of injury vic tims treated in the state of Florida and indicate that the developing traum a system is demonstrating productivity in terms of avoidance of preventable death, efficient management of noninjury comorbid problems, and more compl ete recovery as indicated by proportion of patients discharged to home.