Massachusetts Chapter of the American College of Surgeons

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Impact of Modified Geriatric Trauma Activation criteria at a Level 1 Trauma Center on patient outcomes, a Retrospective Cohort Study
Reginald Alouidor, MD FACS Margaret Siu, MD Sandy Roh, MD Vincent Reginald Narvaez, MD Andrew Litwin, MD Aixa Perez-Carabello, MS MPH Nicole Corriveau Kristine Kramer, MD Edward Kelly, MD FACS Eleanor Winston, MD FACS Tyler Putnam, MD FACS Gabriel Ryb, MD FACS
University of Massachusetts Medical Center-Baystate Health, Springfield, MA

Background: Determine the impact of Modified Geriatric Trauma Activation Criteria on patient outcomes.
Methods: A retrospective cohort study from 08/2015 to 09/2019 at an academic Level 1 Trauma Center. All adults greater than 65 years seen as a Category 1 trauma activation, Category 2, or Trauma consultation. Variables of patient age, mechanism of injury, comorbidities, activation category, survival vs death, ICU admission, discharge disposition, ISS, operative intervention were collected. Initial data analysis described the distribution of all measures. Continuous measures were reported using means, standard deviations, medians, and percentiles. Categorical measures were reported using frequencies and percentages. Differences in subject characteristics between study groups, before and after implementation of modified criteria, were reported.
Results: Study groups were similar in size, n=614 for the standard criteria group and n=574 for study group. ISS, mechanism of injury, and comorbidities between the groups had no statistical difference (p=0.35, 0.08, 0.6, respectively). Modified Geriatric Trauma Activation criteria lead to increased high level trauma activations, n=58 for CAT 1 before, n=145 after. Death in ED and at 30 days between the two groups had no statistical difference (p=0.48 and 0.5, respectively). Operative intervention between two groups had no statistical difference (p=.7). Length of stay between two groups had no statistical difference (p=.25).
Conclusion: Implementation of Modified Geriatric Trauma Activation Criteria does not improve geriatric patient survival or outcomes.


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