ArticleJournal of the American College of Surgeons2013
Triage of elderly trauma patients: a population-based perspective.
Article in Journal of the American College of Surgeons, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06402669 (Time to Hospitalization and Limb Loss in Blunt Extremity Trauma), which is not on this map. Cited by 49 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Time to Hospitalization and Limb Loss in Blunt Extremity Trauma
Who cites it
49 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Configurations and outcomes of acute hospital care for frail and older patients with moderate to major trauma: a systematic review.BMJ open · 2023Pooled it
- Mechanism of injury and special considerations as predictive of serious injury: A systematic review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Pooled it
- National guideline for the field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2021.The journal of trauma and acute care surgery · 2022Guideline
- Under-triage of older trauma patients in prehospital care: a systematic review.European geriatric medicine · 2021Pooled it
- Evaluation of elderly specific pre-hospital trauma triage criteria: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Pooled it
- Diagnostic radiation exposure of injury patients in the emergency department: a cross-sectional large scaled study.PloS one · 2013Trial
- Triage Accuracy and the 2015 Field Trauma Triage Criteria Update.JAMA network open · 2026Article
- Article
- Inpatient Trauma Care Costs in the US From 2012 to 2021.JAMA network open · 2025Article
- The impacts of ageing-related changes on prehospital trauma care for older adults: challenges and future directions.Frontiers in medicine · 2025Review
- Optimizing CT resource use in geriatric trauma: is less sometimes more?Trauma surgery & acute care open · 2025Article
- Optimising prehospital trauma triage for older adults: challenges, limitations, and future directions.Frontiers in medicine · 2025Review
- Efficacy of the Protocol for Trauma Team Activation in Taipei: A Retrospective Study.Emergency medicine international · 2025Article
- Article
- Mortality association with extremity trauma and transferring patients for higher level of care.Annals of medicine and surgery (2012) · 2024Article
- Predicting the complexity and mortality of polytrauma patients with machine learning models.Scientific reports · 2024Article
- The current status of trauma care for older adults in Saudi Arabia.Frontiers in medicine · 2024Review
- Injury outcomes across Canadian trauma systems: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Physicians' experiences and actions in making complex level-of-care decisions during acute situations within older patients' homes: a critical incident study.BMC geriatrics · 2023Article
- Development of Imaging Criteria for Geriatric Blunt Trauma Patients.The Journal of surgical research · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundElderly patients are frequently undertriaged. However, the associations between triage patterns and outcomes from a population perspective are unknown. We hypothesized that triage patterns would be associated with differences in outcomes. STUDY
designThis is a population-based, retrospective, cohort study of all injured adults aged 55 years or older, from 3 counties in California and 4 in Utah (2006 to 2007). Prehospital data were linked to trauma registry data, state-level discharge data, emergency department records, and death files. The primary outcome was 60-day mortality. Patients treated at trauma centers were compared with those treated at nontrauma centers. Undertriage was defined as an Injury Severity Score (ISS) >15, with transport to a nontrauma center.
resultsThere were 6,015 patients in the analysis. Patients who were taken to nontrauma centers were, on average, older (79.4 vs 70.7 years, p < 0.001), more often female (68.6% vs 50.2%, p < 0.01), and less often had an ISS >15 (2.2% vs 6.7%, p < 0.01). There were 244 patients with an ISS >15 and the undertriage rate was 32.8% (n = 80). Overall 60-day mortality for patients with an ISS >15 was 17%, with no difference between trauma and nontrauma centers in unadjusted or adjusted analyses. However, the median per-patient costs were $21,000 higher for severely injured patients taken to trauma centers.
conclusionsThis is the first population-based analysis of triage patterns and outcomes in the elderly. We have shown high rates of undertriage that are not associated with higher mortality, but are associated with higher costs. Future work should focus on determining how to improve outcomes for this population.
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