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Trauma Recidivism in the Elderly

Gubler, K. Dean DO, MPH; Maier, Ronald V. MD; Davis, Robert MD, MPH; Koepsell, Thomas MD, MPH; Soderberg, Robert; Rivara, Frederick P. MD, MPH

The Journal of Trauma: Injury, Infection, and Critical Care: December 1996 - Volume 41 - Issue 6 - p 952-956

Background The incidence of recurrent trauma in the elderly is unknown. This study evaluated the risk of readmission for injury among elderly trauma patients compared with an uninjured geriatric cohort. The effects of age, sex, race, preexisting illness, and ISS on trauma recidivism were determined.

Methods Population based retrospective cohort analysis of the elderly using administrative data from the Health Care Financing Administration was performed. The measured out-come was trauma admission within 5 years. The injured were identified using hospital discharge data and the Injury Severity Score generated by ICD-Map. The uninjured were identified from Medicare eligibility files. Comorbid illness was assessed using ICD-9CM codes from outpatient and inpatient data files.

Results The injured members of the cohort had increased risk of subsequent new trauma admission (p < 0.001). Increasing Injury Severity Score, age, and comorbid illness are associated with trauma recidivism.

Conclusion Trauma in the elderly is recurrent. Further study is required to develop age and injury specific interventions to prevent recurrent injury.

From the Departments of Clinical Investigation and Surgery (K.D.G.), Naval Medical Center San Diego, San Diego, California, Harborview Injury Prevention and Research Center (R.V.M., R.D., T.K., R.S., F.P.R.), Seattle, Washington, Department of Epidemiology, School of Public Health and Community Medicine (R.D., T.K., F.P.R.), Department of Surgery (R.V.M.), and Department of Pediatrics (R.D., F.P.R.), School of Medicine, University of Washington, Seattle, Washington.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of Navy, Department of Defense, nor the United States Government.

The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, DC, Clinical Investigation Program sponsored this Study 84-16-1968-583, as required by HSETC 6000.41A. This research was supported by National Institutes of Health Grant R01-AA-07116 and Center for Disease Control Grant R40-CCR-00-2750.

Presented at the 26th Annual Meeting of the Western Trauma Association, February 26-March 1, 1996, Alta, Wyoming.

Address for reprints: Robert Davis, MD, MPH, Department of Pediatrics, Mailbox #WJ-10, School of Medicine, University of Washington, Seattle, WA 98195.

© Williams & Wilkins 1996. All Rights Reserved.