Women With Low Falls Are Less Likely To Be Admitted to a Specialist Trauma Unit: A Single Centre Observational Study of Older Adults.

backgroundUndertriage of women with trauma is associated with preventable deaths. This project was developed to determine whether older women with trauma were less likely to be admitted to a specialist trauma unit.

methodsThe study was undertaken at a specialist, level one trauma service and included all people aged 65 and older admitted following trauma over a twelve-month period. Patients were included if they were admitted to general medicine, trauma or orthopaedics. The primary outcome was admission to general medicine versus trauma. Baseline data included age, sex, Charlson Comorbidity Index (CCI), mechanism of injury (low fall vs. other) and baseline function. Injury Severity Score (ISS) was calculated by trained assessors.

resultsA total of 648 (50.3%) were admitted to trauma, 286 (22.2%) to orthopaedics and 352 (27.4%) to General medicine (GM). 686 (53%) of patients were women. Low fall was the most common mechanism of injury (75.6% of women, 51.3% of men). In a multivariate model to look at admission to GM versus trauma, including age, sex, language other than English, CCI and ISS, women were more likely to be admitted to GM (1.67 (1.14, 2.44)). Low fall was the biggest predictor of general medical admission versus trauma (11.4 (6.7, 18.9)) Low fall was associated with mortality (2.0 (1.11, 3.67)).

conclusionsAccounting for age and frailty women and people with low falls were more likely to be admitted to a general medical unit than a trauma unit compared to men. This supports the need for standard admission guidelines for trauma.