Is medical urgency of elderly patients with traumatic brain injury underestimated by emergency department triage?

Ruge, ToralphUniv Hosp Skane, Dept Clin Sci Malmo, Lund, Sweden;Karolinska Univ Hosp, Dept Emergency Med, S-17176 Stockholm, Sweden (author)

Background: Mortality is high among elderly patients with traumatic brain injury (TBI). Recent data suggest that early surgical intervention and aggressive rehabilitation may reduce mortality rates even in elderly patients. Our aim was therefore to study the Rapid Emergency Triage and Treatment System-Adult (RETTS-A) triage of patients with isolated TBI and examine the differences in acute management according to age. Methods: We included 306 adult patients with isolated severe TBI and an abbreviated injury scale (AIS) score >= 3. Using a cut-off of 60 years of age, differences in triage priority according to RETTS-A, time to first computed tomography (CT) scan, length of hospital stay (LOS), and 30-day survival were studied. Results: In patients with an AIS score of 3 and 4, we observed that elderly patients had a longer time from admission to first CT scan. In addition, we observed that elderly patients were less often triaged with the highest priority level, despite similar AIS scores. LOS was significantly higher in elderly patients (median 9 days compared with 3 days for younger patients, p < 0.001). Finally, age, triage priority, and AIS score were independent risk factors for mortality. Conclusion: Elderly patients with isolated TBI are managed differently than younger patients, which could be due to an under-triage of elderly patients by RETTS-A.

Carlsson, Axel C.Karolinska Institutet,Uppsala universitet,Institutionen för medicinska vetenskaper,Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden(Swepub:uu)axeca883 (author)
Hellström, MagnusUmeå universitet,Kirurgi,Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden(Swepub:umu)mashem99 (author)
Wihlborg, PerUniv Hosp Skane, Dept Clin Sci Malmo, Lund, Sweden (author)
Undén, JohanHalmstad Cty Hosp, Dept Operat & Intens Care, Halmstad, Sweden;Lund Univ, Anaesthesiol & Intens Care Med, Lund, Sweden (author)
Univ Hosp Skane, Dept Clin Sci Malmo, Lund, Sweden;Karolinska Univ Hosp, Dept Emergency Med, S-17176 Stockholm, SwedenInstitutionen för medicinska vetenskaper (creator_code:org_t)

In:Upsala Journal of Medical Sciences: Taylor & Francis125:1, s. 58-630300-97342000-1967

By the author/editor: Ruge, Toralph; Carlsson, Axel C ...; Hellström, Magnu ...; Wihlborg, Per; Undén, Johan

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

By the university: Umeå University; Uppsala University; Karolinska Institutet

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.