ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Is level 1 trauma care necessary for all severely injured older patients? Evaluating undertriage and feasibility of care in major and non-major trauma centres in the Netherlands.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Validation of the 2022 German trauma team activation criteria: a national registry study with focus on geriatric-specific modifiers.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Trauma patients ≥ 65 years old constitute 40% of severely injured adult trauma patients in Sweden - a 10-year analysis of geriatric trauma prevalence.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUndertriage remains a challenge within the severely injured older patients. The survival benefit in major trauma centres (MTCs) compared to non-major trauma centres (nMTCs) has been disputed. This study aimed to assess the differences in patient characteristics of severely injured older patients treated in MTCs and nMTCs and to regard whether these characteristics could be related to pre-hospital triage decisions and influence clinical outcomes in MTCs and nMTCs.
methodsA retrospective cohort study was conducted, using the Dutch National Trauma Registry to identify all patients of 70 and above with an ISS ≥ 16 during 2016-2022. Patient characteristics and outcomes between MTCs, nMTCs and directly transferred patients were compared. Backward logistic regression analyses were performed to identify factors predicting mortality.
resultsA total of 10,899 patients were included. Patients in nMTCs harboured more octo- and nonagenarians than MTCs (44.6% vs. 37.2% and 15.1% vs. 6.7% resp., p < 0.001). The ISS was significantly lower in nMTCs (median 19 [IQR 17-25] vs. 22 [17-27], p < 0.001), with severe head injury and a low GCS being more prevalent in MTCs. High energy falls were more often observed in MTCs (15.6% vs. 7.7%, p < 0.001). Mortality was significantly lower in nMTCs (OR 0.59, 95%-CI 0.54-0.65), with a GCS 3-8 strongly associated with an increased risk for mortality in both nMTCs and MTCs (OR 19.93, p < 0.001 and OR 7.87, p < 0.001 resp.).
conclusionThe differences in patients presented in MTCs and nMTCs indicate factors contributing to undertriage; severely injured older patients with recognizable injuries and trauma mechanisms are more likely to be presented in a MTC. Whether feasible care for severely injured older patients should be provided in MTCs or nMTCs should not only be dependent on ISS and mortality rates; patient-centred care goals harbouring broader perspectives as frailty and health- and quality-of-life benefit of aggressive injury treatment should also contribute in triage- and treatment decision-making. LEVEL OF EVIDENCE AND STUDY TYPE: Level III, prognostic/epidemiological.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.