Impact of Geriatric Trauma Co-Management on 1-Year Mortality in Older Adults with Multiple Rib Fractures

R I Med J (2013). 2023 May 1;106(4):19-24.

Abstract

Background: Rib fractures in older adults are associated with higher morbidity and mortality. Geriatric trauma co-management programs have looked at in-hospital mortality but not long-term outcomes.

Methods: A retrospective study of multiple rib fracture patients 65 years and older (n=357), admitted from September 2012 to November 2014 comparing Geriatric trauma co-management (GTC) vs Usual Care by trauma surgery (UC). The primary outcome was 1-year mortality.

Results: 38.9% (139) were cared for by GTC. Compared to the UC, GTC patients were older (81.6±8.6 years vs 79±8.5) and had more comorbidities (Charlson 2.8±1.6 vs 2.2±1.6). GTC patients had 46% less chance of dying in 1-year compared to UC (HR 0.54, 95% CI [0.33-0.86]). Conclusions: GTC showed a significant reduction in 1-year mortality even though patients were overall older and more comorbid. This shows multidisciplinary teams are crucial to patient outcomes and should continue to be further explored.

Keywords: frail older adults; geriatric assessments; multiple trauma; ribs fracture.

MeSH terms

  • Aged
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Length of Stay
  • Retrospective Studies
  • Rib Fractures* / therapy