Old age as a criterion for trauma team activation

Background. Elderly trauma patients have been shown to have a worse prognos is than young patients. Age alone is not a criterion for trauma team activa tion (TTA). In the present study, we evaluated the role of age greater than or equal to 70 years as a criterion for TTA. Methods: The present study was a trauma registry study that included injure d patients 70 years of age or older. Patients who died in hospital, were ad mitted to the intensive care unit (ICU) within 24 hours, or had a nonorthop edic operation were assumed to benefit from TTA. Results: During a 7.5-year period, 883 elderly ( greater than or equal to 7 0 years) trauma patients meeting trauma center criteria were admitted to ou r center. Overall, 223 patients (25%) met at least one of the standard TTA criteria. The mortality in this group was 50%, the ICU admission rate was 3 9%, and a nonorthopedic operation was required in 35%. The remaining 660 pa tients (75%) did not meet standard TTA criteria. The mortality was 16%, the need for ICU admission was 24%, and nonorthopedic operations were required in 19%. Sixty-three percent of patients with severe injuries (injury Sever ity Score > 15) and 25% of patients with critical injuries (Injury Severity Score > 30) did not have any of the standard hemodynamic criteria for TTA. Conclusion. Elderly trauma patients have a high mortality, even with fairly minor or moderately severe injuries. A significant number of elderly patie nts with severe injuries do not meet the standard criteria for TTA. It is s uggested that age greater than or equal to 70 years alone should be a crite rion for TTA.