Medicina de Emergência: Acesso Aberto
Acesso livre

Abstrato

Explaining the Difference in the Triage Rate of the Elderly: Are they Undertriaged or Not?

Etienne E Pracht, Barbara Langland-Orban, David Ciesla, Joseph J Tepas and Lewis Flint

In Florida, the percent of injured elderly trauma patients with ICISS < 0.85 who were transported to a designated trauma center (DTC) was only 47.9 in 2013, which was about half the triage rate of non-elderly adults. This present analysis used Florida hospital discharge data to examine the difference in these triage rates by analyzing injury type, severity, and mechanism, distance to a DTC, and severity of comorbidities. Falls were the largest mechanism of injury among severely injured elderly (72.9 percent) yet had the lowest triage rate to DTCs (33.0 percent) among injury mechanism categories. In contrast, motor vehicle accidents (MVAs) were the most frequent for non-elderly adults (54.9 percent), which were associated with relatively high triage rates for both severely injured non-elderly and elderly (88.4 and 70.9, respectively). The severity of comorbid conditions may explain why severely injured elderly patients are less likely to be transported to a DTC. The severity of comorbidities among the elderly had a greater association with mortality than the ICISS, creating a need for paramedics to determine whether the DTC or closest hospital is the better alternative. The elderly have equal geographic access to trauma centers in Florida; however, they are less likely to use them, particularly for ground level falls, which often do not require surgery.