Triaging older major trauma patients in the emergency department: an observational study.
BACKGROUND
The objective of this study was to compare the triage category assigned to older trauma patients with younger trauma patients upon arrival to the emergency department. The focus was to examine whether older major trauma patients were less likely to be assigned an emergency triage category on arrival to the emergency department after controlling for relevant demographics, injury characteristics and injury severity.


METHODS
This was an observational study using data from the Queensland Trauma Registry. All trauma patients aged 15 years and older who presented to contributing hospitals between 1 January 2005 and 31 December 2009 with an Injury Severity Score (ISS)>15 were included. Logistic regression analysis examined the odds of assignment to emergency (Australasian Triage Scale (ATS) 1 or 2) versus urgent (ATS 3-5) treatment for patients across various age categories after adjustment for relevant demographics, injury characteristics and injury severity.


RESULTS
The study used data on 6923 patients with a median (IQR) age of 43 (26-62) years and a mortality of 11.4% (95% CI 10.7% to 12.2%). Compared with individuals aged 15-34, the adjusted odds of being assigned an ATS category 1 or 2 were 30% lower (OR=0.68, 95% CI 0.57 to 0.81) for individuals aged 55-75 years and were 50% lower (OR=0.46, 95% CI 0.37 to 0.56) for individuals aged 75 years or older.


CONCLUSIONS
Among patients with an ISS>15, older major trauma patients were less likely to be assigned an emergency triage category compared with younger patients. This suggests that the elderly may be undertriaged and provides a potential area of study for reducing mortality and morbidity in older trauma patients.
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia.
William
W
Lukin
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia School of Public Health, Queensland University of Technology, Herston, Queensland, Australia.
Jaimi H
JH
Greenslade
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia.
Kevin
K
Chu
Centre of National Research on Disability and Rehabilitation Medicine, School of Medicine, The University of Queensland, Herston, Queensland, Australia.
Jacelle
J
Lang
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia School of Medicine, The University of Queensland, Herston, Queensland, Australia.
Anthony F T
AF
Brown
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011793:Queensland / Q000453:epidemiology; D012042:Registries; D014218:Triage; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*
Trauma; triage