The authors of a recent retrospective study examined trauma center admissions among elderly patients. The analysis included admissions data on adults 18 years of age and older who were hospitalized for acute traumatic injuries at acute care hospitals in California during a 10-year period ending in December 2008. A total of 430,081 records were examined; 27% of patients were 65 or older (and constituted the elderly group). A majority of the elderly patients were women (65%, compared with 24% in the nonelderly group), and there was a lower percentage of black patients in the elderly group (2%, compared with 7%) as well as a higher percentage of white patients (66%, compared with 33%). The elderly group had a smaller percentage of patients with severe injuries than the nonelderly group (4%, compared with 7%) but a slightly larger percentage of moderately injured patients (41%, compared with 39%). Elderly patients had more comorbidities, and 82% of injuries in patients 65 or older were caused by falls (the percentage in patients over 85 was 93%).

Analysis revealed a significant inverse relationship between increasing age and the likelihood of trauma center referral, a trend that remained consistent after adjusting for injury type and severity and other variables. The data show that, regardless of injury severity, insurance, income, distance from a trauma center, and trauma center availability, California trauma patients who are 65 or older are less likely to be admitted to a trauma center than younger trauma patients. The authors note that this trend is alarming in light of the growing number of elderly people in the United States.

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