Evidence map›Paper›PMID 38970303›Full record

ArticleJournal of the American Geriatrics Society2024

The geriatric trauma hospitalist service: An analysis of a management strategy for injured older adults.

Heather R Kregel, Claudia Pedroza, Fatimah Sunez, Gina Khraish, Ezenwa Onyema, David E Meyer, Sasha D Adams, Lillian S Kao, Laura J Moore, Thaddeus J Puzio

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Geriatric Models of Surgical Care: A Scoping Review.Journal of advanced nursing · 2026
    Article
  2. Article
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.

Heather R KregelDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Claudia PedrozaMcGovern Medical School at UTHealth, The Institute for Clinical Research and Learning Health Care, Houston, Texas, USA.
Fatimah SunezDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Gina KhraishDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Ezenwa OnyemaDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
David E MeyerDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Sasha D AdamsDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Lillian S KaoDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Laura J MooreDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Thaddeus J PuzioDivision of Acute Care Surgery, Department of Surgery, McGovern Medical School at UTHealth, Houston, Texas, USA.

Funding

ROLE OF THE GUT IN POST INJURY MULTIPLE ORGAN FAILURET32GM008792 · NIGMS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI Charles S Cox · 2001 to 2026
$5.2M
Howell Family FoundationJack H. Mayfield MD Chair in SurgeryJames H. "Red" Duke ProfessorshipNIGMS NIH HHS 5T32GM008792NIGMS NIH HHS T32 GM008792William Stamps Farish Fund
6 · The paper itself

Abstract

backgroundManagement of geriatric trauma patients requires balancing chronic comorbidities with acute injuries. We developed a care model in which patients are managed by hospitalists with trauma-centered education and hypothesized that clinical outcomes would be similar to outcomes in patients primarily managed by trauma surgeons.

methodsThis was a retrospective study of trauma patients aged ≥65 from January 2020 to December 2021. Groups were defined by admitting service: trauma surgery service (TSS) or geriatric trauma hospitalist service (GTHS). The primary outcome was in-hospital mortality. Regression analyses and inverse probability treatment weighted (IPTW) propensity score (PS) analyses were performed to determine the association between admitting service and outcomes.

resultsA total of 1004 patients were eligible for inclusion-580 GTHS and 424 TSS admissions. GTHS patients were older (82 vs. 74, p < 0.001), more likely to have suffered blunt trauma (99.5% vs. 95%, p < 0.001), more likely to have comorbidities (91.2% vs. 87%, p < 0.001), had higher Charlson Comorbidity Indexes (CCIs), and had lower median injury severity scores (9 vs. 13, p < 0.001). Rates of mortality, delirium, 30-day readmission, and overall complications were low and similar between groups. While TSS patients were likely to be discharged home, GTHS had more discharges to skilled nursing facilities and longer length of stay (LOS). On multivariable analysis adjusted for age, ISS, CCI, and sex, patients admitted to GTHS had lower odds of death with an odds ratio of 0.15 (95% confidence interval [CI] 0.02-0.75, p = 0.03) when compared to TSS. On IPTW PS analysis, patients admitted to GTHS had similar odds of death with an odds ratio of 0.3 (95% CI 0.06-1.6, p = 0.16).

conclusionsProtocolized admission criteria to a GTHS resulted in similar low mortality rates but longer LOS when compared to patients admitted to a TSS. This care model may inform other trauma centers in developing their strategies for managing the increasing volume of vulnerable injured older adults.

Indexed as

HospitalistsHospital MortalityTrauma CentersWounds and InjuriesAgedAged, 80 and overComorbidityFemaleGeriatricsHumansInjury Severity ScoreLength of StayMalePropensity ScoreRetrospective Studiesgeriatric admissiongeriatric traumatrauma hospitalist

Identifiers

PMID38970303
PMCPMC11368630

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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.