Pre-hospital and admission parameters predict in-hospital mortality among patients 60 years and older following severe trauma

Background The world population of inhabitants of greater than 60 years of age has doubled since 1980 and is predicted to reach 2 billion by 2050 [1]. Trauma is the sixth leading cause of death in patients over 60 years of age [2]. Though this growing elderly population only comprises 12% of overall trauma patients, they consume considerable medical resources [3] and are more likely to require hospital admission [4]. An aggressive approach should be established throughout the management of the elderly trauma patient in order to reduce mortality and the incidence of permanent disability [5]. In the past decade, the overall mortality rate due to trauma decreased. However, in the elderly population (>65 years of age), the incidence of trauma-related mortality is still high, mostly secondary to falls [6]. Elderly patients have a higher mortality after trauma as well as a higher complication rate, specifically for pulmonary and infectious complications [7,8]. Trauma in the elderly clearly poses special challenges to the physician, with physiological changes of age impacting morbidity and mortality. Notwithstanding, little information is available regarding risk factors that aid in predicting increased mortality in this population. More so, there are significant findings in the literature showing that severely injured geriatric trauma patients who do survive their hospitalization have appreciable long-term survival and return to independent living [9-11]. Our study is a retrospective review of our experience with severely injured elderly patients. Our primary objectives were to describe the different pattern of injury among the elderly and define and analyze predictors of in-hospital mortality. Our secondary objective was to