Geriatric trauma hospitalization in the United States: A population-based study

The objective of this study was to characterize elderly trauma hospitalizat ions nationwide. Elderly Medicare beneficiaries hospitalized in 1989, with trauma as a primary or secondary diagnosis, were studied cross-sectionally. Descriptive analyses and primary mortality rates among different levels of trauma center designation were provided. Estimated relative risks, chi-squ are tests of association, and multivariate logistic regression were perform ed. There were 577,193 geriatric trauma patients admitted to 5227 short-sta y U.S. hospitals. Level one trauma centers constituted less than 4% of hosp itals, but admitted 7.5% of patients, including disproportionate numbers of blacks, males, and patients with more severe primary injury diagnoses. Ris k of inpatient death increased with age, male gender, black race, and sever ity of injury. Level one trauma center patients displayed a 1.49 greater ri sk for inpatient death even after controlling for confounding variables in a multivariate model. This population-based study provides a detailed natio nal picture of the elderly trauma hospitalization experience, contrasting p rofiles and outcomes between hospitals with and without designated trauma c enters. Although demonstrating higher inpatient mortality rates, Level one trauma centers admit a decidedly different patient population than other ho spitals, which is disproportionately younger, black and male and includes t he most severely injured geriatric patients. Additional confounding factors should be explored. (C) 2001 Elsevier Science Inc. All rights reserved.