title: Ambulance transport rates after motor vehicle collision for older vs. younger adults: a population-based study.
abstract: Older adults are at greater risk than younger adults for life-threatening injury after motor vehicle collision (MVC). Among those with life-threatening injury, older adults are also at greater risk of not being transported by emergency medical services (EMS) to an emergency department. Despite the greater risk of serious injury and non-transportation among older adults, little is known about the relationship between patient age and EMS transportation rates for individuals experiencing MVC. We describe transport rates across the age-span for adults seen by EMS after experiencing MVC using data reported to the North Carolina Department of Motor Vehicles between 2008 and 2011. Of all adults aged 18 years and older experiencing MVC and seen by EMS (n=484,310), 36.3% (n=175,768) were transported to an emergency department. Rates of transport for individuals seen by EMS after MVC increased only a small amount with increasing patient age. After adjusting for potential confounders of the relationship between patient age and the decision to transport (patient gender, patient race, air bag deployment, patient trapped or ejected, and injury severity), transport rates were: age 18-64=36.0% (95% confidence interval [CI], 35.9-36.2%); age 65-74=36.6% (95% CI, 36.0-37.1%); age 75-84=37.3% (95% CI, 36.5-38.1%), and age 85-94=38.2% (95% CI, 36.7-39.8%). In North Carolina between 2008 and 2011, the transportation rate was only slightly higher for older adults than for younger adults, and most older adults experiencing MVC and seen by EMS were not transported to the emergency department. These findings have implications for efforts to improve the sensitivity of criteria used by EMS to determine the need for transport for older adults experiencing MVC.
authors.affiliation: University of Virginia School of Medicine, United States.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Hunold
authors.affiliation: University of Virginia, Department of Emergency Medicine, United States.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Sochor
authors.affiliation: University of North Carolina, Department of Emergency Medicine, United States; University of North Carolina, Department of Anesthesiology, United States.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: McLean
authors.affiliation: University of North Carolina, United States.
authors.forename: Kaitlyn B
authors.initials: KB
authors.lastname: Mosteller
authors.affiliation: University of North Carolina, Department of Emergency Medicine, United States.
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Fernandez
authors.affiliation: University of North Carolina, Department of Emergency Medicine, United States; University of North Carolina, Department of Anesthesiology, United States. Electronic address: tplattsm@med.unc.edu.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014218:Triage; D014947:Wounds and Injuries; D055815:Young Adult
keywords: Emergency medical services; Geriatrics; Motor vehicle collision; Triage