Evidence map›Paper›PMID 26814513›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2014

Age and mortality after injury: is the association linear?

R S Friese, J Wynne, B Joseph, A Hashmi, C Diven, V Pandit, T O'Keeffe, B Zangbar, N Kulvatunyou, P Rhee

Abstract read
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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Geriatric polytrauma patients should not be excluded from aggressive injury treatment based on age alone.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Article
  3. Article
  4. Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2020
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

R S FrieseDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
J WynneDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
B JosephDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA. bjoseph@surgery.arizona.edu.
A HashmiDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
C DivenDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
V PanditDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
T O'KeeffeDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
B ZangbarDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
N KulvatunyouDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.
P RheeDivision of Trauma, Critical Care, Burn and Emergency Surgery, Department of Surgery, University of Arizona College of Medicine, 1501 N. Campbell Ave., Room 5411, P.O. Box 245063, Tucson, AZ, 85727, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMultiple studies have demonstrated a linear association between advancing age and mortality after injury. An inflection point, or an age at which outcomes begin to differ, has not been previously described. We hypothesized that the relationship between age and mortality after injury is non-linear and an inflection point exists.

methodsWe performed a retrospective cohort analysis at our urban level I center from 2007 through 2009. All patients aged 65 years and older with the admission diagnosis of injury were included. Non-parametric logistic regression was used to identify the functional form between mortality and age. Multivariate logistic regression was utilized to explore the association between age and mortality. Age 65 years was used as the reference. Significance was defined as p < 0.05.

resultsA total of 1,107 patients were included in the analysis. One-third required intensive care unit (ICU) admission and 48 % had traumatic brain injury. 229 patients (20.6 %) were 84 years of age or older. The overall mortality was 7.2 %. Our model indicates that mortality is a quadratic function of age. After controlling for confounders, age is associated with mortality with a regression coefficient of 1.08 for the linear term (p = 0.02) and a regression coefficient of -0.006 for the quadratic term (p = 0.03). The model identified 84.4 years of age as the inflection point at which mortality rates begin to decline.

conclusionsThe risk of death after injury varies linearly with age until 84 years. After 84 years of age, the mortality rates decline. These findings may reflect the varying severity of comorbidities and differences in baseline functional status in elderly trauma patients. Specifically, a proportion of our injured patient population less than 84 years old may be more frail, contributing to increased mortality after trauma, whereas a larger proportion of our injured patients over 84 years old, by virtue of reaching this advanced age, may, in fact, be less frail, contributing to less risk of death.

Indexed as

Geriatric traumaIntensive care unit admission and old ageOld age and mortalityOutcome is elderly trauma patients

Identifiers

PMID26814513

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.