High risk trauma in older adults in Hong Kong: a multicentre study.
BACKGROUND
Trauma is the eighth leading cause of death in Hong Kong. In 2002, 18.5% of the population of Hong Kong was aged 55 years or above, which increased to 22.1% in 2006. The increasing older population in Hong Kong presents a challenge to the health care system yet there is little local data on older trauma patients. The objectives of this study are firstly to describe the epidemiology of high risk trauma in older patients in Hong Kong, and secondly to identify predictors of trauma mortality.


METHODS
Retrospective analysis of prospectively collected data from a centralised trauma database; data collected from 2002 to 2004 from four trauma centres in Hong Kong.


RESULTS
Between 2002 and 2004, the four trauma centres had a total of 2,124,175 emergency department attendances of which 376,021 (17.7%) were trauma patients, and 80,827 (3.8%) were aged 55 years or older. 810 injured older patients met the inclusion criteria for this study. 380 (46.9%) patients had co-morbidity at the time of injury. Common causes of injury were falls (50.0%, 405/810) and motor vehicle crashes (33.6%, 272/810) of which (77.2%, 210/272) were pedestrians. Mortality was 24.4% (198/810) and increased with advancing age (p<0.0001). 53.5% (433/810) of patients had major trauma (ISS>15). Head injury contributed to 80.3% (159/198) of deaths. 38.4% (311/810) of patients required operations. Most patients were discharged home (40.5%, 328/810) and one-third (270/810) required rehabilitation. Significant predictors of mortality included co-morbidity, injury severity score, age and decreasing Glasgow Coma Score.


CONCLUSIONS
Pedestrians struck by motor vehicles and falls are the principal causes of trauma in older patients in Hong Kong. Mortality increased with advancing age. The independent indicators of trauma mortality in older patients are co-morbidity, age, ISS and GCS.
Yeung
Janice H H
JH
Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong SAR, People's Republic of China.
Chang
Annice Ling Mui
AL
Ho
Wendy
W
So
Fung Ling
FL
Graham
Colin A
CA
Cheng
Beatrice
B
Cheung
N K
NK
Ho
H F
HF
Yuen
W K
WK
Kam
C W
CW
Rainer
Timothy H
TH
D000368:Aged; D005260:Female; D015600:Glasgow Coma Scale; D006723:Hong Kong / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000209:etiology