Elderly patients treated in regular emergency rooms have higher mortality rates after release
WEDNESDAY, OCT. 23, 2013 (HealthDay News) -- Although traumatic injuries can be even more dangerous for the elderly than for other adults, these patients often do not receive the specialized care they need, according to a new study.
Many older people with serious injuries are not taken to designated trauma centers -- which are equipped with the technology and tools doctors need to treat traumatic injuries -- to receive specialized care, the researchers said. These patients have a higher mortality rate after they are discharged from the hospital, the study found.
"We're not sure why this is happening, but there is clearly a bias," study lead author Dr. Kristan Staudenmayer, assistant professor of surgery at Stanford University School of Medicine in Stanford, Calif., said in a news release from the American College of Surgeons. "They could be walking through the living room, trip, and fall. That [event] may not hurt a young person, but it can severely injure an elderly person, especially if that elderly person is frail and has a lot of other health conditions."
Unintentional falls are the most common cause of traumatic injuries -- such as spine, hip and brain injuries -- among adults older than 65, the researchers noted.
Without considering older people's underlying health conditions, first responders may not realize the extent of their injuries, the study authors said.
"Even if we know they have heart disease or another condition, that's not sufficient to tell us how strong or weak they are," said Staudenmayer. "I know plenty of people with diabetes who look pretty healthy."
The study, published in the October issue of the Journal of the American College of Surgeons, involved information compiled on more than 6,000 patients aged 55 and older injured between January 2006 and December 2007. The researchers examined state hospital discharge reports, patient records, emergency department records, trauma registry data and death certificates in order to compare patient outcomes 60 days after being discharged from the hospital.
The patients treated at designated trauma centers had a 60-day mortality rate of 5.7 percent, compared to 9 percent at other hospitals, the study found. The median length of stay at trauma centers was also one day shorter than other hospitals.
About 4 percent of the patients in the study had a serious injury that needed specialized care at a trauma center. Of these patients, nearly one-third should have been taken to a trauma center but were not.
However, death rates were similar at designated trauma centers and nontrauma centers, the findings showed. Elderly patients often die after they are discharged from the hospital, the study authors pointed out.
"This result actually leads to more questions," Staudenmayer said. "We need to determine which elderly patients actually are benefiting from trauma care and who would benefit more."
The study also found that receiving care at trauma centers cost more than $20,000 more than care received at nontrauma centers.
"Ensuring that specialized medical care and extra resources [are available] costs more money at a trauma center," Staudenmayer explained.
More than 2.3 million nonfatal injuries among older adults are treated in emergency rooms each year, costing about $30 billion in direct medical care, according to the U.S. Centers for Disease Control and Prevention.
The U.S. Centers for Disease Control and Prevention has more about injury prevention and control among older adults (http://www.cdc.gov/TraumaticBrainInjury/olderadults.html ).
SOURCE: The American College of Surgeons, news release, Oct. 16, 2013