title: The impact of discharging minimally injured trauma patient: does age play a role in trauma admission?
abstract: BACKGROUND
  Age is suggested as a triage criteria for transfer to a trauma center, despite poor outcomes after similar injury regardless of trauma center level. The effect of differential triage based on age to a trauma center has not been evaluated. We hypothesized that there would be a difference in the admission rates of geriatric patients compared with the rest of the adult trauma population independent of injury severity.
  
  
  METHODS
  Records of 1,970 adult patients evaluated by the trauma team at a Level I trauma center and discharged directly from the emergency department were reviewed. Data abstracted included demographics, injuries, and physiologic information. These data were compared with 3,232 trauma patients admitted over the same time period who had similar information abstracted via record review. χ analysis of the admission rates of geriatric patients was performed, followed by a binomial logistic regression to determine factors that affected the odds of admission.
  
  
  RESULTS
  A total of 451 (8.68%) patients were 65 years or older; 62.2% of the total population was admitted. Significantly more geriatric patients (82%) were admitted (χ = 126.24; p < 0.001). Multivariate analysis showed that age, head injury, Injury Severity Score, Glasgow Coma Scale, and initial blood pressure were significant independent factors in predicting hospital admission (p < 0.001).
  
  
  CONCLUSIONS
  Age alone is associated with increased odds of being admitted to the hospital, independent of injury severity and other physiologic parameters. This has implications for trauma centers that see a significant proportion of geriatric trauma patients and for trauma systems that must prepare for the "aging of America."
authors.affiliation: Division of Trauma/Critical Care, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Peschman
authors.forename: Todd
authors.initials: T
authors.lastname: Neideen
authors.forename: Karen
authors.initials: K
authors.lastname: Brasel
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D016009:Chi-Square Distribution; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D010343:Patient Admission; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000458:organization & administration*; D014218:Triage