Citation

Kopatsis A, Chetram VK, Kopatsis K, Morin N, Wagner C. J. Emerg. Trauma Shock 2019; 12(3): 192-197.

Affiliation

School of Medicine, St. George's University, Grenada, West Indies, Grenada.

Copyright

(Copyright © 2019, INDO-US Emergency and Trauma Collaborative, Publisher Medknow Publications)

DOI

10.4103/JETS.JETS_145_18

PMID

31543642

PMCID

PMC6735205

Abstract

BACKGROUND: Nonagenarians represent a rapidly growing age group who often have functional limitations and multiple comorbidities, predisposing them to trauma. AIMS: The purpose of this study was to identify patient characteristics, hospital complications, and comorbidities that predict in-hospital mortality in the nonagenarian population following trauma. We also sought to create a scoring system using these variables. SETTINGS AND DESIGN: This study was a retrospective chart review.

METHODS: We reviewed the medical records of 548 nonagenarian trauma patients admitted to two Level I trauma centers from 2006 to 2015. Statistical analysis was performed using logistic regression and a machine learning model, which calculated significant variables and computed a scoring system.

RESULTS: The in-hospital mortality rate was 7.1% (n = 39). Significant predictors of mortality were cardiac comorbidity, neuro-concussion, New Injury Severity Score (ISS) 16+, striking an object, ISS 25-75, and pulmonary and cardiac complications. Significant variables were assigned a numeric value. A score of 5+ carried a 41.1% mortality risk, 79% sensitivity, and 91% specificity. A score of 10+ had an associated 81.8% mortality risk with 31% specificity and 99% sensitivity.

CONCLUSIONS: Our findings identified reliable predictors of mortality in nonagenarian population posttrauma. The scoring system performs with good specificity and sensitivity and incrementally correlates with mortality risk.

Language: en

Keywords

Mortality risk; nonagenarian; trauma