The vulnerable elders survey-13 predicts hospital complications and mortality in older adults with traumatic injury: a pilot study.

OBJECTIVES To determine whether the Vulnerable Elders Survey (VES)-13, a survey based on functional status that has been validated in uninjured older populations, will predict complications and mortality in injured older adults. DESIGN Prospective observational pilot study. SETTING Level 1 trauma center. PARTICIPANTS Sixty-three older adults (≥65) with a traumatic injury who survived and required inpatient care for at least 24 hours. MEASUREMENTS PREDICTOR preinjury VES-13 score (0-10 points, higher=greater risk) obtained by interviewing participants or proxies. OUTCOMES composite outcome of one or more medical complications (e.g., aspiration pneumonia, respiratory failure) or death, discharge destination (home, nursing home, death), length of stay, hospital charges. Covariates: Charlson Comorbidity Index (CCI), Injury Severity Score (ISS), and sex. RESULTS Of the 63 participants, 30 (48%) were discharged to home and 28 (44%) to a nursing facility, 21 (33%) developed one or more complications, and four (6%) died. In a model that also controlled for ISS and comorbidity, each additional VES-13 point was associated with greater risk of complication or death (odds ratio=1.53 per point, 95% confidence interval=1.12-2.07). CONCLUSION The VES-13, in combination with injury severity, may be useful early in the hospital course to predict complications and death in older adults with traumatic injury, potentially identifying candidates who may benefit from additional inpatient geriatric services.