@article{ref1,
title="Trauma center transfer of elderly patients with mild Traumatic Brain Injury improves outcomes",
journal="American journal of surgery",
year="2019",
author="Velez, Ana M. and Frangos, Spiros G. and Dimaggio, Charles J. and Berry, Cherisse D. and Avraham, Jacob B. and Bukur, Marko",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Elderly patients with Traumatic Brain Injury (TBI) are frequently transferred to designated Trauma Centers (TC). We hypothesized that TC transfer is associated with improved outcomes. <br><br>METHODS: Retrospective study utilizing the National Trauma Databank. Demographics, injury and outcomes data were abstracted. Patients were dichotomized by transfer to a designated level I/II TC vs. not. Multivariate regression was used to derive the adjusted primary outcome, mortality, and secondary outcomes, complications and discharge disposition. <br><br>RESULTS: 19,664 patients were included, with a mean age of 78.1 years. 70% were transferred to a level I/II TC. Transferred patients had a higher ISS (12 vs. 10, p < 0.001). Mortality was significantly lower in patients transferred to level I/II TCs (5.6% vs. 6.2%, Adjusted Odds Ratio (AOR) 0.84, p = 0.011), as was the likelihood of discharge to skilled nursing facilities (26.4% vs. 30.2%, AOR 0.80, p < 0.001). <br><br>CONCLUSIONS: Elderly patients with mild TBI transferred to level I/II TCs have improved outcomes. Which patients with mild TBI require level I/II TC care should be examined prospectively.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2019.06.008",
url="http://dx.doi.org/10.1016/j.amjsurg.2019.06.008"
}