Geriatric Trauma Outcome Score and Mortality in Elderly Trauma Patients: A Retrospective Cohort Study

Abstract

Background: The aging population in Thailand is rapidly increasing, leading to a rise in elderly trauma cases. Understanding the epidemiology, causes, complications, and outcomes of geriatric trauma is crucial for improving care and developing preventive strategies. Objective: To analyze the epidemiological patterns, causes, complications, and outcomes of elderly trauma patients, and to assess the relationship between the Geriatric Trauma Outcome Score (GT OS) and mortality. Materials and Methods: This retrospective study included 466 patients aged 60 years and older who were diagnosed with trauma between 2011 and 2021 at Chiang Mai University Hospital. Medical records were retrospectively reviewed, and data were extracted between September 2022 and July 2023. Statistical analyses included descriptive statistics, Fisher’s exact test, Student’s t-test, and univariable and multiple risk regression analyses. Results: The majority of patients were over 65 years old (77.68%) and male (51.93%). Falls (62.66%) and traffic accidents (24.68%) were the main causes of injury. The mortality rate was 3.43%. Pneumonia (RR 1.54, 95% CI 1.02 to 2.33, p=0.040) and failed or difficult intubation (RR 1.81, 95% CI 1.15 to 2.85, p=0.010) were significant predictors of mortality. GT OS showed good predictive ability for mortality (AUC 0.807, 95% CI 0.73 to 0.88). Factors associated with high GT OS included age >65 years, ISS >15, and blood transfusion. Conclusion: Falls are the primary cause of injury in elderly patients, with a significant impact on mortality. GT OS is an effective tool for predicting mortality in this population. Prevention strategies need to focus on fall prevention, and care protocols should address the specific needs of elderly trauma patients.