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Abstract
Background Patients >64 years of age now represent more than 51% of injury hospitalisations in Canada. The tools used to identify older patients who could benefit the most from an interdisciplinary approach include complex parameters difficult to collect in the ED, which suggests that better tools with higher accuracy and using items that can be derived from routinely collected data are needed. We aimed to identify variables that are associated with adverse outcomes in older patients admitted to a trauma centre for an isolated orthopaedic injury.
Methods We conducted a multicentre retrospective cohort study between 1 April 2013 and 31 March 2019 on older patients hospitalised with a primary diagnosis of isolated orthopaedic injury (n=19 928). Data were extracted from the provincial trauma registry (Registre des traumatismes du Québec). We used multilevel logistic regression to estimate the associations between potential predictors and adverse outcomes (extended length of stay, mortality, complications, unplanned readmission and adverse discharge destination).
Results Increasing age, male sex, specific comorbidities, type of orthopaedic injuries, increasing number of comorbidities, severe orthopaedic injury, head injuries and admission in the year before the injury were all significant predictors of adverse outcomes.
Conclusion We identified eight predictors of adverse outcomes in patients >64 years of age admitted to a trauma centre for orthopaedic injury. These variables could eventually be used to develop a clinical decision rule to identify elders who may benefit the most from interdisciplinary care.
- orthopedic
- fractures
- predictors
- geriatrics
Data availability statement
The data are available upon request.
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Data availability statement
The data are available upon request.
Footnotes
Handling editor Mary Dawood
Contributors CJI carried out the study, developed the methodology, performed the analysis and wrote the manuscript. LM and CED contributed to the development of research objectives and inclusion criteria, critically revised and approved the final version of the manuscript, and supervised all phases of this work. MB contributed to the development of research objectives and inclusion criteria, and critically revised and approved the final version of the manuscript. AB, GA, EB, MG, DT, CM and ME critically revised and approved the final version of the manuscript. CJI, LM, and CED act as guarantors of this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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