Prehospital undertriage of older injured patients in western Switzerland: an observational cross-sectional study.
Details
Serval ID
serval:BIB_2141A7C42F7C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prehospital undertriage of older injured patients in western Switzerland: an observational cross-sectional study.
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN
1757-7241 (Electronic)
ISSN-L
1757-7241
Publication state
Published
Issued date
08/10/2024
Peer-reviewed
Oui
Volume
32
Number
1
Pages
100
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: epublish
Publication Status: epublish
Abstract
The ageing of the population is leading to an increase in the number of traumatic injuries and represents a major challenge for the future. Falls represent the leading cause of Emergency department admission in older people, with injuries ranging from minor to severe multiple injuries. Older injured patients are more likely to be undertriaged than younger patients. The aim of this study was to investigate the extent of undertriage in older patients with particular emphasis on access to trauma centres and resuscitation rooms.
Retrospective observational cross-sectional study based on data prospectively collected from prehospital electronic records including all patients ≥ 18 years for whom an ambulance or helicopter was dispatched between 1 January 2018 and 31 April 2023 due to a trauma. The primary outcome, admission to the resuscitation room of the regional trauma centre with trauma team activation, was assessed by age. Multivariate logistic regression was used to control for known confounders and to test for plausible effect modifiers.
Emergency Medical Services treated 37,906 injured patients. Older patients ≥ 75 years represented 17,719 patients (47%). Admission to trauma centre with trauma team activation was lower in older patients, N = 121 (1%) compared to N = 599 (5%) in younger patients, p < 0.001; adjusted odds ratio: 0.33 (0.24-0.45); p < 0.001. Undertriage increased by twofold with age ≥ 75; OR: 1.81 (1.04-3.15); p value < 0.001. Undertriaged patients were older, more likely to be female, to have low energy trauma and to be located farther from the regional trauma centre.
Older injured patients were at increased risk of undertriage and non-trauma team activation admission, especially if they were older, female, had head injury without altered consciousness and greater distance to regional trauma centre.
Retrospective observational cross-sectional study based on data prospectively collected from prehospital electronic records including all patients ≥ 18 years for whom an ambulance or helicopter was dispatched between 1 January 2018 and 31 April 2023 due to a trauma. The primary outcome, admission to the resuscitation room of the regional trauma centre with trauma team activation, was assessed by age. Multivariate logistic regression was used to control for known confounders and to test for plausible effect modifiers.
Emergency Medical Services treated 37,906 injured patients. Older patients ≥ 75 years represented 17,719 patients (47%). Admission to trauma centre with trauma team activation was lower in older patients, N = 121 (1%) compared to N = 599 (5%) in younger patients, p < 0.001; adjusted odds ratio: 0.33 (0.24-0.45); p < 0.001. Undertriage increased by twofold with age ≥ 75; OR: 1.81 (1.04-3.15); p value < 0.001. Undertriaged patients were older, more likely to be female, to have low energy trauma and to be located farther from the regional trauma centre.
Older injured patients were at increased risk of undertriage and non-trauma team activation admission, especially if they were older, female, had head injury without altered consciousness and greater distance to regional trauma centre.
Keywords
Humans, Triage, Cross-Sectional Studies, Aged, Female, Male, Switzerland/epidemiology, Retrospective Studies, Emergency Medical Services, Trauma Centers/organization & administration, Wounds and Injuries/therapy, Aged, 80 and over, Middle Aged, Injury Severity Score, Adult, Age Factors, Frail elderly, Injuries, Older adults, Prehospital, Trauma
Pubmed
Web of science
Open Access
Yes
Create date
11/10/2024 15:01
Last modification date
31/10/2024 7:13