Is medical urgency of elderly patients with traumatic brain injury underestimated by emergency department triage?
Ups J Med Sci
; 125(1): 58-63, 2020 Feb.
Article
in En
| MEDLINE
| ID: mdl-31986958
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.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Triage
/
Emergency Service, Hospital
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Brain Injuries, Traumatic
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Ups J Med Sci
Year:
2020
Document type:
Article
Affiliation country:
Sweden
Country of publication:
Sweden