Evidence map›Paper›PMID 37742324›Full record

ArticleCJEM2023

Predictors of mortality among older major trauma patients.

Krishan Yadav, Jacinthe Lampron, Richard Nadj, Rikesh Raichura, Sonshire Figueira, Marie-Joe Nemnom, Monica Taljaard, Marcel Émond, Axel Benhamed, Debra Eagles

Abstract read
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In one paragraph

Article in CJEM, 2023. 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. Short-term impact of preinjury antithrombotic therapy on outcomes in older trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
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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.

Krishan YadavDepartment of Emergency Medicine, Clinical Epidemiology Unit F660b, University of Ottawa, Ottawa, ON, Canada. kyadav@toh.ca.ORCID 0000-0002-1547-4634
Jacinthe LampronOttawa Hospital Research Institute, Ottawa, ON, Canada.
Richard NadjUndergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Rikesh RaichuraUndergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Sonshire FigueiraDepartment of Surgery, University of Ottawa, Ottawa, ON, Canada.
Marie-Joe NemnomOttawa Hospital Research Institute, Ottawa, ON, Canada.
Monica TaljaardOttawa Hospital Research Institute, Ottawa, ON, Canada.
Marcel ÉmondDépartement de Médecine de Famille Et de Médecine d'urgence, Université Laval, Québec, QC, Canada.
Axel BenhamedService SAMU-Urgences, Centre Hospitalier Universitaire Édouard Herriot-Université Claude Benard, Lyon, France.
Debra EaglesDepartment of Emergency Medicine, Clinical Epidemiology Unit F660b, University of Ottawa, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder trauma patients have a higher mortality yet are more likely to be under-triaged compared to younger patients. Studies have suggested that current trauma team activation criteria are suboptimal for older patients.

objectivesThe objective was to describe trauma care delivered, patient outcomes, and to identify variables independently associated with mortality.

methodsWe performed a health records review from 2014 to 2020 of older (age ≥ 65 years) trauma patients presenting to a level one trauma centre with any of the following: injury severity score (ISS) > 12, and all trauma team activations or admission to the trauma ward. The primary outcome was 30-day all-cause mortality. Secondary outcomes included injury mechanism and trauma care delivered. Multivariable logistic regression was used to identify factors independently associated with 30-day all-cause mortality. Multiple imputation was used to deal with missing data.

resultsWe enrolled 1,380 patients (mean age 80 years, mean ISS 18); 26.8% had multimorbidity (≥ 2 chronic conditions) and 65.9% met criteria for polypharmacy (≥ 5 medications). The most common mechanism was fall from standing height (61.1%). Thirty-day all-cause mortality occurred in 239 (17.3%) patients. A Glasgow coma scale (GCS) < 15 (odds ratio [OR] = 5.55; 95% CI 3.73-8.24), ISS > 15 (OR = 3.75, 95% CI 2.35-6.01), age ≥ 85 years (OR = 2.04, 95% CI 1.29-3.22), anticoagulation with a direct oral anticoagulant (DOAC) or warfarin (OR = 1.59, 95% CI 1.08-2.35) and multimorbidity (OR = 1.53, 95% CI 1.06-2.22) were significantly associated with increased risk 30-day mortality (C-statistic = 0.82, 95% CI 0.79-0.85). Dementia (OR = 0.61, 95% CI 0.40-0.95) and time to CT scan > 60 min (OR = 0.50, 95% CI 0.34-0.74) were associated with decreased mortality risk.

conclusionWe identified five factors associated with increased 30-day mortality in older trauma patients: GCS < 15, ISS > 15, age ≥ 85 years, anticoagulation, and multimorbidity. These factors should be considered when developing modified trauma team activation criteria for older adults.

Indexed as

AnticoagulantsTrauma CentersAgedAged, 80 and overGlasgow Coma ScaleHumansInjury Severity ScoreLogistic ModelsRetrospective StudiesAnticoagulantsAgedMortalityTrauma

Identifiers

PMID37742324

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.