title: Post-trauma mortality increase at age 60: a cutoff for defining elderly?
abstract: BACKGROUND
  There has been an increasing emphasis on identifying elderly trauma patients. However, definitions based solely on age vary widely, ranging from age 55 to 80 years, hampering optimal trauma management for older patients. The goal of this study was to develop an objective, data-driven definition for "elderly" in trauma care by evaluating mortality risk as a function of age.
  
  
  METHODS
  We conducted a retrospective analysis of 872,861 adult (≥18 years) patients from the National Trauma Data Bank's National Sample Program from 2003 to 2010. The primary outcome was risk-adjusted in-hospital mortality determined using multivariate logistic regression. Contribution of age to mortality was investigated through step-wise regression and percent of R2attributable to age. We searched for straight-line trends in mortality rate at each age using the spline function of Statistical Analysis Software.
  
  
  RESULTS
  Statistically significant increases in mortality rate were noted at ages 37, 60, and 78. Age was found to contribute 10% to mortality compared with greater than 80% for Glasgow coma scale and injury severity score combined.
  
  
  CONCLUSIONS
  Our findings suggest using age 60 years as a data-driven definition of "elderly" in trauma.
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA. Electronic address: mcampbel01@jpshealth.org.
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Campbell-Furtick
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors.forename: Billy J
authors.initials: BJ
authors.lastname: Moore
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Overton
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Laureano Phillips
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors.forename: Kaley J
authors.initials: KJ
authors.lastname: Simon
authors.affiliation: Surgery, John Peter Smith Health Network, Fort Worth, TX, USA.
authors.forename: Rajesh R
authors.initials: RR
authors.lastname: Gandhi
authors.affiliation: Acute Care Surgery, John Peter Smith Health Network, Fort Worth, TX, USA.
authors.forename: Therese M
authors.initials: TM
authors.lastname: Duane
authors.affiliation: John Peter Smith Health Network, Research Institute, 1500 S. Main St., Fort Worth, TX 76104, USA.
authors.forename: Shahid
authors.initials: S
authors.lastname: Shafi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult
keywords: Age cutoff; Elderly age; Elderly trauma; Geriatric trauma; Mortality