Document Detail


The effect of age, severity, and mechanism of injury on risk of death from major trauma in Western Australia.
MedLine Citation:
PMID:  23354264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined the association between age, mechanism of injury, and Injury Severity Score (ISS) on mortality in major trauma.
METHODS: We used 9 years of population-based linked major trauma (ISS >15) registry data for Western Australia (N = 4,411). These were categorized using the Sampalis classification of injury severity: survivable (ISS 16-24), probably survivable (ISS 25-49), and nonsurvivable (ISS 50+). Age was categorized as younger than 15 years, 15 to 64 years, and 65 years or older. Multivariable linear logistic regression analysis was used to examine the risk of death.
RESULTS: Motor vehicle crashes (MVCs) were most prominent for those younger than 65 years, and falls dominated the 65 years and older group. The median ISS for the three age groups were 20, 25, and 24, respectively (p = 0.001). The proportion of deaths in the three groups were 7.2%, 11.5%, and 30.1%, respectively (p = 0.0001). Falls were the most common cause of death. The inflexion point, above which the risk of death increases exponentially, was age 47 years. For the potentially survivable ISS 25 to 49 group, the inflexion point was age 25 years. After adjusting for age and ISS, falls had the greatest risk for death (odds ratio, 1.62; 95% confidence interval, 1.21-2.18). A lower ISS had a disproportionate effect on the elderly.
CONCLUSION: The risk for major trauma death increases as age increases, with the inflexion point at age 47 years. Those younger than 15 years have a significantly lower ISS. The elderly have an increased risk for death following falls.
LEVEL OF EVIDENCE: Epidemiologic study, level II.
Authors:
Daniel M Fatovich; Ian G Jacobs; Stephen A Langford; Michael Phillips
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  74     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  2013-04-05     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  647-51     Citation Subset:  AIM; IM    
Affiliation:
University of Western Australia, Crawley, Western Australia, Australia. daniel.fatovich@health.wa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic / mortality
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Infant
Injury Severity Score
Logistic Models
Male
Middle Aged
Risk Factors
Western Australia / epidemiology
Wounds and Injuries / etiology,  mortality*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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