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Erschienen in: European Journal of Trauma and Emergency Surgery 5/2014

01.10.2014 | Original Article

Age and mortality after injury: is the association linear?

verfasst von: R. S. Friese, J. Wynne, B. Joseph, A. Hashmi, C. Diven, V. Pandit, T. O’Keeffe, B. Zangbar, N. Kulvatunyou, P. Rhee

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2014

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Abstract

Introduction

Multiple studies have demonstrated a linear association between advancing age and mortality after injury. An inflection point, or an age at which outcomes begin to differ, has not been previously described. We hypothesized that the relationship between age and mortality after injury is non-linear and an inflection point exists.

Methods

We performed a retrospective cohort analysis at our urban level I center from 2007 through 2009. All patients aged 65 years and older with the admission diagnosis of injury were included. Non-parametric logistic regression was used to identify the functional form between mortality and age. Multivariate logistic regression was utilized to explore the association between age and mortality. Age 65 years was used as the reference. Significance was defined as p < 0.05.

Results

A total of 1,107 patients were included in the analysis. One-third required intensive care unit (ICU) admission and 48 % had traumatic brain injury. 229 patients (20.6 %) were 84 years of age or older. The overall mortality was 7.2 %. Our model indicates that mortality is a quadratic function of age. After controlling for confounders, age is associated with mortality with a regression coefficient of 1.08 for the linear term (p = 0.02) and a regression coefficient of −0.006 for the quadratic term (p = 0.03). The model identified 84.4 years of age as the inflection point at which mortality rates begin to decline.

Conclusions

The risk of death after injury varies linearly with age until 84 years. After 84 years of age, the mortality rates decline. These findings may reflect the varying severity of comorbidities and differences in baseline functional status in elderly trauma patients. Specifically, a proportion of our injured patient population less than 84 years old may be more frail, contributing to increased mortality after trauma, whereas a larger proportion of our injured patients over 84 years old, by virtue of reaching this advanced age, may, in fact, be less frail, contributing to less risk of death.
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Metadaten
Titel
Age and mortality after injury: is the association linear?
verfasst von
R. S. Friese
J. Wynne
B. Joseph
A. Hashmi
C. Diven
V. Pandit
T. O’Keeffe
B. Zangbar
N. Kulvatunyou
P. Rhee
Publikationsdatum
01.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 5/2014
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0380-0

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