Should age be a factor to change from a level II to a level I trauma activation?

The Journal of Trauma
Vanessa K ShiffletteErnest L Dunn

Abstract

Elderly trauma patients have a higher incidence of medical comorbidities when compared with their younger cohorts. Currently, the minimally accepted criteria established by the Committee on Trauma for the highest level of trauma activation (Level I) does not include age as a factor. Should patients older than 60 years with multiple injuries and/or a significant mechanism of injury be considered as part of the criteria for Level I activation? Would these patients benefit from a higher level of activation? The National Trauma Data Bank was queried for the period of January 1, 1999, to December 31, 2008, for all trauma patients and associated injury severity score (ISS). The data abstracted were based on age and ISS. The National Trauma Data Bank contained 802,211 trauma patients. Seventy-nine percent were younger than 60 years, and 21% were older than 60 years. Our analysis shows that in all levels of injury, patients older than 60 years have an increased risk for morbidity and mortality. We found a threefold increase in morbidity and a fivefold increase in mortality among the older (age >60 years) population with a minor ISS. Elderly patients with a major ISS demonstrated a twofold increase in morbidity and a fourfold increase i...Continue Reading

References

Jun 1, 1992·Archives of Surgery·C W Schwab, D R Kauder
Feb 1, 1990·The Journal of Trauma·T M ScaleaG W Shaftan
Apr 11, 1990·JAMA : the Journal of the American Medical Association·J A MorrisS L Edelstein
May 1, 1989·The Journal of Trauma·F C FinelliW J Fouty
Feb 1, 1989·The Journal of Trauma·R M ShorrR A Cowley
Nov 1, 1987·The Journal of Trauma·E J DeMariaD S Gann
Jan 1, 1994·Archives of Surgery·A SauaiaD C Lezotte
Jun 24, 2000·The Journal of Trauma·E M BulgerG J Jurkovich
Oct 5, 2001·The Journal of Trauma·D DemetriadesT V Berne
Sep 26, 2002·The British Journal of Surgery·D DemetriadesW Shoemaker
Mar 14, 2003·The Journal of Trauma·Eric BergeronMarcel Martin
Jun 19, 2003·The Journal of Trauma·Demetrios DemetriadesLinda Chan
Oct 1, 1955·Circulation·M BRANDFONBRENERN W SHOCK
Aug 25, 2004·Journal of the American College of Surgeons·Demetrios DemetriadesPeter Rhee
Feb 12, 2005·The Journal of Trauma·Demetrios DemetriadesPeter Rhee
Apr 28, 2009·American Journal of Surgery·Ryan LehmannMatthew Martin

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Citations

Sep 15, 2011·Age and Ageing·Christine Geraldine McMahonFiona Lecky
Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Austin PorterRobert Todd Maxson
Dec 3, 2014·American Journal of Surgery·Connie M DeLa'ORussell D Dumire
May 4, 2011·Brain Injury : [BI]·Christian ZeckeyChristian Probst
Dec 4, 2013·American Journal of Surgery·Alicia Mangram
Sep 24, 2013·Journal of the American College of Surgeons·Kristan L StaudenmayerCraig D Newgard
Nov 28, 2012·Clinics in Geriatric Medicine·Stephanie Bonne, Douglas J E Schuerer
Jan 18, 2016·Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial·Y PeñascoJ Llorca
Sep 25, 2014·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Carsten SchoenebergSven Lendemans
Nov 29, 2014·Case Reports in Orthopedics·Simon Parker, Arash Afsharpad
Feb 9, 2012·The Journal of Trauma and Acute Care Surgery·Alicia J MangramErnest L Dunn
Jul 6, 2014·The American Journal of Emergency Medicine·Huiyun XiangKathryn Jo Haley
Mar 17, 2015·The Orthopedic Clinics of North America·Leonard T BullerFernando E Vilella
Sep 29, 2018·Development and Psychopathology·Amy Lehrner, Rachel Yehuda
Mar 9, 2019·Journal of the American Geriatrics Society·Elizabeth R HeitzMelinda C Power
Aug 10, 2011·The Journal of Trauma·Niels D MartinMichael S Weinstein
Jan 30, 2020·Health Services Research·Linda J Scheetz, John P Orazem
Apr 18, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Fabrizio A FiumedinisiThomas Gross
Jan 28, 2021·The American Surgeon·Chelsea M KnottsBryan K Richmond
Jan 13, 2021·Journal of Clinical Medicine·Daniel PoppMaximilian Kerschbaum

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