Risk Factors Associated With Worse Outcomes in Trauma Patients Aged 55 and Older

Authors

Hector Mendez, HCA Florida Kendall HospitalFollow
Ilko Luque, HCA Florida Kendall HospitalFollow
Nicole Yordán López, HCA Florida Kendall HospitalFollow
Carlos Parra, Ponce Health Sciences UniversityFollow
Kelvin Chan, HCA Florida Bayonet Point HospitalFollow
Mariel A. Javier, HCA Florida Kendall HospitalFollow
Marcela Ramirez, HCA Florida Kendall HospitalFollow
Orlando Morejón, HCA Florida Kendall HospitalFollow

Keywords

trauma; comorbidity; hospital mortality; treatment outcome; aged; elderly; risk factors; intensive care unit; wounds and injuries

Disciplines

Trauma

Abstract

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to assess which PECs were associated with in-hospital mortality, acute kidney injury (AKI), ventilator-associated pneumonia (VAP), and unplanned intensive care unit (ICU) admission.

Results

We identified 5168 trauma patients 55 years old and older, of which 54.9% were female. Chronic renal failure (CRF) increased the odds of in-hospital mortality (adjusted odds ratio [aOR] = 2.30, P < .001), unplanned ICU admission (aOR = 1.73, P = .033), and AKI (aOR = 2.97, P < .001). Congestive heart failure (CHF) increased the odds of in-hospital mortality (aOR = 1.75, P < .001), unplanned ICU admission (aOR = 2.64, P < .001), and VAP (aOR = 2.42, P = .047). Cirrhosis increased the odds of in-hospital mortality (aOR = 3.78, P = .007), unplanned ICU admission (aOR = 3.11, P = .007), and AKI (aOR = 3.78, P = .007).

Conclusion

Our analysis showed an association between certain comorbidities and poor outcomes in geriatric trauma patients 55 years old and older; namely, CRF, CHF, and cirrhosis were linked to increased in-hospital mortality, unplanned ICU admission, and the development of complications. Identifying these risk factors can aid in developing protocols to improve monitoring and complication-reduction strategies.

Recommended Citation

Mendez, Hector; Luque, Ilko; Yordán López, Nicole; Parra, Carlos; Chan, Kelvin; Javier, Mariel A.; Ramirez, Marcela; and Morejón, Orlando (2025) "Risk Factors Associated With Worse Outcomes in Trauma Patients Aged 55 and Older," HCA Healthcare Journal of Medicine: Vol. 6: Iss. 1, Article 9.
DOI: 10.36518/2689-0216.1830
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol6/iss1/9