Event Title
Geriatric Motorcycle-Related Outcomes: A Pennsylvania Multicenter Study
Location
Philadelphia, PA
Start Date
3-5-2023 1:00 PM
End Date
3-5-2023 4:00 PM
Description
Introduction: Geriatric patients (GP) often experience increased morbidity and mortality following traumatic insult and as a result, require more specialized care due to lower physiologic reserve and underlying medical comorbidities. Motorcycle injuries (MCC) occur across all age groups, however, no large-scale studies evaluating outcomes of GP exist with data thus far limited to recreational based studies. We hypothesized that geriatric MCC will face worse outcomes and utilize more hospital resources despite greater helmet usage compared with their younger counterparts.
Methods: We performed multicenter retrospective review of MCC patients at three Pennsylvania level I trauma centers from January 2016 to December 2020. Data was extracted from each institution’s electronic medical records and trauma registry. GP were defined as patients greater than or equal to 65 years of age. The primary outcome was mortality. Secondary outcomes included ventilator days (VD) and hospital (HLOS), intensive care unit (ICU LOS), and intermediate unit (IMU LOS) length of stays. 3:1 [(nongeriatric patients (NGP) to GP] propensity score matching (PSM) was based on sex, abbreviated injury scale (AIS) and injury severity score (ISS). p≤0.05 was considered significant.
Results: 1538 (GP:7%[n=113]; NGP:93%[n=1425]) patients were included. Median ISS (GP:10 vs NG:6), median Charleston Comorbidity Index (GP:3 vs NGP:0), and helmet usage (GP:76.9% vs NGP:58.8%) were higher in GP (p≤0.05), however, mortality rates were similar (GP:1.7% vs NGP:2.6%; p=0.99). Following PSM (n=488), GP had significantly more comorbidities (p≤0.05). There was no difference in trauma bay interventions or complications between cohorts. Mortality remained similar between cohorts post-PSM (GP:1.8% vs NGP:3.2%; p=0.417). Differences in ventilator days as well as ICU LOS, IMU LOS and HLOS were negligible. Helmet usage (GP:64.5% vs NGP:66.8%; p=0.649) and insurance status (GP:87.4% vs NGP:91.5%; p=0.189) between groups were similar. Helmet use was more prevalent among insured NGP compared with those without insurance (69.1% vs 46.2%; p≤0.05).
Conclusion: When matched for sex, ISS and AIS, age was not associated with interventions, complications, ventilator days, length of stay or mortality. There was no significant difference in helmet usage or insurance status between groups. Based on our study, there is no strong evidence for altering initial management of motorcycle-related trauma in geriatric patients.
Embargo Period
9-1-2023
Geriatric Motorcycle-Related Outcomes: A Pennsylvania Multicenter Study
Philadelphia, PA
Introduction: Geriatric patients (GP) often experience increased morbidity and mortality following traumatic insult and as a result, require more specialized care due to lower physiologic reserve and underlying medical comorbidities. Motorcycle injuries (MCC) occur across all age groups, however, no large-scale studies evaluating outcomes of GP exist with data thus far limited to recreational based studies. We hypothesized that geriatric MCC will face worse outcomes and utilize more hospital resources despite greater helmet usage compared with their younger counterparts.
Methods: We performed multicenter retrospective review of MCC patients at three Pennsylvania level I trauma centers from January 2016 to December 2020. Data was extracted from each institution’s electronic medical records and trauma registry. GP were defined as patients greater than or equal to 65 years of age. The primary outcome was mortality. Secondary outcomes included ventilator days (VD) and hospital (HLOS), intensive care unit (ICU LOS), and intermediate unit (IMU LOS) length of stays. 3:1 [(nongeriatric patients (NGP) to GP] propensity score matching (PSM) was based on sex, abbreviated injury scale (AIS) and injury severity score (ISS). p≤0.05 was considered significant.
Results: 1538 (GP:7%[n=113]; NGP:93%[n=1425]) patients were included. Median ISS (GP:10 vs NG:6), median Charleston Comorbidity Index (GP:3 vs NGP:0), and helmet usage (GP:76.9% vs NGP:58.8%) were higher in GP (p≤0.05), however, mortality rates were similar (GP:1.7% vs NGP:2.6%; p=0.99). Following PSM (n=488), GP had significantly more comorbidities (p≤0.05). There was no difference in trauma bay interventions or complications between cohorts. Mortality remained similar between cohorts post-PSM (GP:1.8% vs NGP:3.2%; p=0.417). Differences in ventilator days as well as ICU LOS, IMU LOS and HLOS were negligible. Helmet usage (GP:64.5% vs NGP:66.8%; p=0.649) and insurance status (GP:87.4% vs NGP:91.5%; p=0.189) between groups were similar. Helmet use was more prevalent among insured NGP compared with those without insurance (69.1% vs 46.2%; p≤0.05).
Conclusion: When matched for sex, ISS and AIS, age was not associated with interventions, complications, ventilator days, length of stay or mortality. There was no significant difference in helmet usage or insurance status between groups. Based on our study, there is no strong evidence for altering initial management of motorcycle-related trauma in geriatric patients.
Comments
Presented by Megan Sullivan.