RETROSPECTIVE SURVEY OF THE CHARACTERISTICS OF IN-PATIENT GERIATRIC TRAUMA PATIENTS TREATED AT MINHUANG HOSPITAL SHANGHAI, PEOPLE’S REPUBLIC OF CHINA DURING 2022-2023

Abstract

Geriatric trauma is a major cause of morbidity in an aging population.  In this study, we aimed to retrospectively determine the types of injuries among trauma in-patients aged ≥60 years hospitalized at Minhang Hospital, Shanghai, People’s Republic of China during 1 June 2022-1 June 2023 in order to inform efforts to improve trauma care in this patient population.  Inclusion criteria for study subjects were being aged ≥60 years and being admitted because of trauma to the study hospital during the study period.  The exclusion criterion was having incomplete medical records.  The medical records of each study subject were reviewed and the following data were recorded: selected demographic characteristics (subject gender and age), history of underlying disease, hospital department of treatment, admitting diagnosis, discharge diagnosis, ICD-10 codes, cause of the injury, location of trauma, whether or not surgery was conducted, whether or not the subjects were treated in the intensive care unit (ICU), whether the injuries involved multiple sites and the outcome of treatment.  A total of 546 subjects were included in the study, 62.6% (n = 342) were females.  The mean (± standard deviation) age of study subjects was 74 (± 9) (range: 60-101) years.  Of the total of 546 subjects, 200 (36.6%) had a lower extremity injury, 80 (14.7%) had an upper extremity injury, 61 (11.2%) had a lumbar spine injury and 47 (8.6%) had a cranial injury.  Surgery was performed on 307 patients (56.2%), and 31 (5.7%) were admitted to the ICU.  A total of 17 patients (3.1%) died, with 13 deaths (76.5%) due to multiple injuries.  Age (p = 0.605), surgery  (p = 0.439) and ICU treatment (p = 0.635) were not significantly associated with survival.  In summary, the most common injuries in our study subjects were lower extremity injuries, followed by upper extremity, spine and cranial injuries.  We found no factors significantly associated with mortality in this cohort, including surgeries and ICU care.  We conclude that non-surgical, non-ICU management of the elderly trauma patients in this study population is reasonable.  Further studies are needed to determine which subjects should have surgery, which should be managed non-surgically, which should be managed in the ICU and which do not need ICU management.  A larger, multi-center study involving a larger number of subjects might better answer these questions and allow applicability to other populations.