Long-term survival of elderly trauma patients

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

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Objective: To evaluate the long-term survival and factors that influence survival among a cohort of elderly trauma patients compared with an uninjured cohort. Design: A retrospective cohort analysis. Data Sources: Health Care Finance Administration, Baltimore, Md, Medicare data. Subjects: A cohort of elderly patients (n=9424) hospitalized for injury in 1987 was identified using Medicare hospital discharge abstract data. An uninjured comparison group (n=37 787) was identified from Medicare eligibility files. For injured patients, an Injury Severity Score was generated from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) codes. For both cohorts, preexisting illness was assessed by ICD-9CM codes from Health Care Finance Administration outpatient and inpatient data files for 1986 and 1987. Main Outcome Measures: Relative risk for mortality within 5 years subsequent to injury, adjusted for age, sex, and preexisting illness, using Cox proportional hazard regression. Results: The injured cohort had a significantly reduced 5-year survival when compared with the uninjured group (relative risk [RR]=1.71; 95% confidence interval, 1.66-1.77). The lower survival persisted even among patients who survived at least 3 years after injury. Coexisting disease, age, and Injury Severity Score were strong predictors of survival. Conclusions: The adverse effect of trauma on survival in elderly patients is not isolated to the immediate postinjury period, but lasts years after the trauma episode. Further study is required to identify the reasons for this persistent effect of trauma on subsequent survival.

Original languageEnglish (US)
Pages (from-to)1010-1014
Number of pages5
JournalArchives of Surgery
Volume132
Issue number9
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Survival
Wounds and Injuries
International Classification of Diseases
Medicare
Preexisting Condition Coverage
Injury Severity Score
Information Storage and Retrieval
Delivery of Health Care
Baltimore
Inpatients
Cohort Studies
Outpatients
Outcome Assessment (Health Care)
Confidence Intervals
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Gubler, K. D., Davis, R., Koepsell, T., Soderberg, R., Maier, R. V., & Rivara, F. P. (1997). Long-term survival of elderly trauma patients. Archives of Surgery, 132(9), 1010-1014. https://doi.org/10.1001/archsurg.1997.01430330076013

Long-term survival of elderly trauma patients. / Gubler, K. Dean; Davis, Robert; Koepsell, Thomas; Soderberg, Robert; Maier, Ronald V.; Rivara, Frederick P.

In: Archives of Surgery, Vol. 132, No. 9, 01.01.1997, p. 1010-1014.

Research output: Contribution to journalArticle

Gubler, KD, Davis, R, Koepsell, T, Soderberg, R, Maier, RV & Rivara, FP 1997, 'Long-term survival of elderly trauma patients', Archives of Surgery, vol. 132, no. 9, pp. 1010-1014. https://doi.org/10.1001/archsurg.1997.01430330076013
Gubler KD, Davis R, Koepsell T, Soderberg R, Maier RV, Rivara FP. Long-term survival of elderly trauma patients. Archives of Surgery. 1997 Jan 1;132(9):1010-1014. https://doi.org/10.1001/archsurg.1997.01430330076013
Gubler, K. Dean ; Davis, Robert ; Koepsell, Thomas ; Soderberg, Robert ; Maier, Ronald V. ; Rivara, Frederick P. / Long-term survival of elderly trauma patients. In: Archives of Surgery. 1997 ; Vol. 132, No. 9. pp. 1010-1014.
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