Survival among injured geriatric: Patients during construction of a statewide trauma system

Background: Patient outcomes are presumed to vary during early implementati on of a trauma system because of fluctuations in processes of care. This st udy estimates risk-adjusted survival for injured geriatric patients during implementation of the Washington State trauma system. Methods: A presystem (1988-1992) versus early construction phase (1993-1995 ) retrospective cohort analysis of hospitalized geriatric injured patients in Washington State was conducted, Hospital data were cross-linked to death certificates, providing patient follow-up. A Cox proportional hazards mode l assessed survival to 60 days from hospital admission. Results: A total of 77,136 geriatric patients were assessed. No difference in survival was observed (before vs. after) for all geriatric injured patie nts. However, among severely injured patients (Injury Severity Score > 15), survival during the implementation phase increased by 5.1% compared with p atients admitted during the presystem years (p = 0.03), Conclusion: This study demonstrates improved survival for seriously injured geriatric trauma patients during construction of the Washington State trau ma system.