Geriatric trauma service: a one-year experience.
BACKGROUND
Trauma centers nationwide have been experiencing an increase in their elderly trauma patients because of an ever growing elderly population within the United States. Many studies have demonstrated the physiologic differences between an older trauma patient versus a younger trauma patient. Coupling these differences with their coexisting medical comorbidities, makes caring for this population extremely challenging. To meet these challenges, we organized a geriatric trauma unit specifically designed with a multidisciplinary approach to take a more aggressive stance to the care of the geriatric trauma patient.


METHODS
We created a geriatric trauma unit at our Level II trauma facility, called the G-60 unit. This unit opened for admission in August 2009. Inclusion criteria included all trauma patients older than 60 years. Data were abstracted from our G-60 unit from the period of August 2009 to July 2010. We compared these data to a similar patient population (control group) from January 2008 to December 2008.


RESULTS
Our Trauma Data Bank yielded 673 patients for the above queried time period. The G-60 group contained 393 patients, while the control group had 280 patients. A decrease was seen among the G-60 group in all categories: average emergency department length of stay (LOS), average emergency department to operating room time, average surgical intensive care unit LOS, and average hospital LOS. A 3.8% mortality rate was found in the G-60 group compared with a 5.7% mortality rate in the control group. Our analysis also showed rate of 0% pneumonia, 1.3% respiratory failure, and 1.5% urinary tract infection in the G-6O group, while the control group had a rate of 1.8% pneumonia, 6.8% respiratory failure, and 3.9% urinary tract infection.


CONCLUSIONS
Our data from the 1-year experience of our G-60 unit show that addressing the specific needs of elderly trauma patients will lead to better outcomes.
Department of General Surgery, Methodist Dallas Medical Center, Dallas, Texas 75203, USA.
Alicia J
AJ
Mangram
Christopher D
CD
Mitchell
Vanessa K
VK
Shifflette
Manuel
M
Lorenzo
Michael S
MS
Truitt
Anuj
A
Goel
Mark A
MA
Lyons
Deborah J
DJ
Nichols
Ernest L
EL
Dunn
D000367:Age Factors; D000368:Aged; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013781:Texas / Q000453:epidemiology; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology / Q000401:mortality / Q000628:therapy