Survival among injured geriatric patients during construction of a statewide trauma system

J Trauma. 2001 Jun;50(6):1111-6. doi: 10.1097/00005373-200106000-00022.


Background: Patient outcomes are presumed to vary during early implementation of a trauma system because of fluctuations in processes of care. This study estimates risk-adjusted survival for injured geriatric patients during implementation of the Washington State trauma system.

Methods: A presystem (1988-1992) versus early construction phase (1993-1995) retrospective cohort analysis of hospitalized geriatric injured patients in Washington State was conducted. Hospital data were cross-linked to death certificates, providing patient follow-up. A Cox proportional hazards model assessed survival to 60 days from hospital admission.

Results: A total of 77,136 geriatric patients were assessed. No difference in survival was observed (before vs. after) for all geriatric injured patients. However, among severely injured patients (Injury Severity Score > 15), survival during the implementation phase increased by 5.1% compared with patients admitted during the presystem years (p = 0.03).

Conclusion: This study demonstrates improved survival for seriously injured geriatric trauma patients during construction of the Washington State trauma system.

MeSH terms

  • Aged
  • Female
  • Health Plan Implementation / organization & administration*
  • Humans
  • Injury Severity Score
  • Male
  • Multiple Trauma / mortality*
  • Multiple Trauma / therapy
  • Outcome Assessment, Health Care
  • Proportional Hazards Models
  • Regional Medical Programs / organization & administration*
  • Retrospective Studies
  • Statistics, Nonparametric
  • Survival Analysis
  • Trauma Centers / organization & administration*
  • Washington / epidemiology