Does the pattern of injury in elderly pedestrian trauma mirror that of the younger pedestrian?
BACKGROUND
Walking is the primary mode of transportation for people aged 65 y and over; hence pedestrian injuries are a substantial source of morbidity and mortality among elderly patients in the United States. This study is aimed at evaluating the pattern of injury in the elderly pedestrians and how it differs from younger patients.


METHODS
Retrospective analysis of the National Trauma Data Bank (2002-2006) was performed, with inclusion criteria defined as pedestrian injuries based on ICD-9 codes, excluding age < 15 y. The following age categories in years were created: 15-24 (reference group), 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and 85-89. The injury prevalence was compared, and multivariate regression for mortality was conducted adjusting for demographic and injury characteristics.


RESULTS
A total of 79,307 patients were analyzed. Superficial injuries were the most common at 29.1%, with lower extremity fractures and intracranial injuries following at 25.1% and 21.4% respectively. The very elderly (75-84 and 85-89) had significantly higher rates of fractures of the pelvis(16.2% and 16.8% versus 8.1% in the youngest group), upper (19.3% and 18.4% versus 9.8%), lower extremities (31.1% and 31.9% versus 22.5%) and intracranial injuries (25.5% and 28.7% versus 22.4%), but sustained lower rates of hepatic (2.3% and 1.7% versus 3.0%) injuries, with no difference seen in pancreatic, splenic, and genitourinary injuries. On multivariate analysis, very elderly patients were six to eight times more likely to die (OR 6.24 and 8.27, P < 0.001).


CONCLUSIONS
Elderly patients have higher rates of fractures and intracranial injuries with an extremely worse mortality after pedestrian trauma.
Department of Surgery, Howard University College of Medicine, Washington, DC 20060, USA. ssiram@howard.edu
Suryanarayana M
SM
Siram
Victor
V
Sonaike
Oluwaseyi B
OB
Bolorunduro
Wendy R
WR
Greene
Sonja Z
SZ
Gerald
David C
DC
Chang
Edward E
EE
Cornwell
Tolulope A
TA
Oyetunji
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology / Q000401:mortality; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016138:Walking; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult