Background: Trauma and pre-existing conditions (PECs) can independently impact patient hospital length of stay (H-LOS) or intensive care unit (ICU) ICU-LOS. Pre-existing conditions impact on LOS has rarely been studied in older trauma patients aged ≥55. Our purpose is to examine the relationship between PEC status and ICU-LOS and H-LOS in this population.
Methods: This is a 3-year retrospective study, for calendar years 2020 through 2022. Multiple linear regression was used for analysis. Confounding factors were controlled for. Statistical significance was defined as P < 0.05.
Results: There were 5168 patients (54.9% female) reviewed. The age breakdown was 51.6% were 70-80 years old. The injury breakdown showed 49.1% mild injury. The mean H-LOS was 6.00 and mean ICU-LOS was 2.55. Having certain PECs increases H-LOS, including congestive heart failure (CHF) by 2.29 days (P < 0.001), chronic obstructive pulmonary disease (COPD) by 1.10 days (P < 0.001), and chronic renal failure (CRF) by 0.96 days (P = 0.02). Increases in ICU-LOS were associated with having certain PECs, specially CRF by 1.03 days (P < 0.001) and CHF by 1.47 days (P < 0.001).
Conclusion: Older trauma patients aged ≥55 with certain PECs had an associated increase in ICU and hospital length of stay. Identifying PEC is essential for the care and management of any patient. Identification of PECs on injured patients is essential since this can prolong the LOS. Early involvement of specialists in patient care directed to each PEC may improve these outcomes.
Keywords: ICU length of stay; hospital length of stay; older patients; pre-existing conditions; trauma.