title: Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis.
abstract: BACKGROUND
  The rate of mortality and factors predicting worst outcomes in the geriatric population presenting with trauma are not well established. This study aimed to examine mortality rates in severe and extremely severe injured individuals 65 years or older and to identify the predictors of mortality based on available evidence in the literature.
  
  
  METHODS
  We performed a systematic literature search on studies reporting mortality and severity of injury in geriatric trauma patients using MEDLINE, PubMed, and Web of Science.
  
  
  RESULTS
  An overall mortality rate of 14.8% (95% confidence interval [CI], 9.8-21.7%) in geriatric trauma patients was observed. Increasing age and severity of injury were found to be associated with higher mortality rates in this patient population. Combined odds of dying in those older than 74 years was 1.67 (95% CI, 1.34-2.08) compared with the elderly population aged 65 years to 74 years. However, the odds of dying in patients 85 years and older compared with those of 75 years to 84 years was not different (odds ratio, 1.23; 95% CI, 0.99-1.52). A pooled mortality rate of 26.5% (95% CI, 23.4-29.8%) was observed in the severely injured (Injury Severity Score [ISS] ≥ 16) geriatric trauma patients. Compared with those with mild or moderate injury, the odds of mortality in severe and extremely severe injuries were 9.5 (95% CI, 6.3-14.5) and 52.3 (95% CI, 32.0-85.5; p ≤ 0.0001), respectively. Low systolic blood pressure had a pooled odds of 2.16 (95% CI, 1.59-2.94) for mortality.
  
  
  CONCLUSIONS
  Overall mortality rate among the geriatric population presenting with trauma is higher than among the adult trauma population. Patients older than 74 years experiencing traumatic injuries are at a higher risk for mortality than the younger geriatric group. However, the trauma-related mortality sustains the same rate after the age of 74 years without any further increase. Moreover, severe and extremely severe injuries and low systolic blood pressure at the presentation among geriatric trauma patients are significant risk factors for mortality.
  
  
  METHODS
  Systematic review and meta-analysis, level IV.
authors.affiliation: From the Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Ammar
authors.initials: A
authors.lastname: Hashmi
authors.forename: Irada
authors.initials: I
authors.lastname: Ibrahim-Zada
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Hassan
authors.initials: H
authors.lastname: Aziz
authors.forename: Mindy J
authors.initials: MJ
authors.lastname: Fain
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D006801:Humans; D015601:Injury Severity Score; D012307:Risk Factors; D014947:Wounds and Injuries / Q000401:mortality*