Team-Based Geriatric Protocol Cuts Trauma Mortality
Major Finding: Mortality significantly improved for geriatric patients on the high-risk protocol (odds ratio, 0.63.
Data Source: A cross-sectional, retrospective analysis of 4,534 elderly trauma patients
Disclosures: Dr. Bradburn and Dr. Schulman reported no relevant conflicts of interest.
FROM THE ANNUAL MEETING OF THE EASTERN ASSOCIATION FOR THE SURGERY OF TRAUMA
At the meeting, Dr. Schulman also asked whether the high DNR rate of 20% could have contributed to the results. Dr. Bradburn responded that if a DNR is put into the regression model, it actually makes the results better, changing the odds ratio from 0.63 to 0.36.
Dr. Bradburn said his team had hoped to investigate functional outcomes, but that these data were not complete.
He noted that the current study is limited by its retrospective design and acknowledged that "from our data you cannot fully attribute its success solely to one part of our protocol." Still, he said, the benefits are "clear."
"This study lays the groundwork for a prospective multi-institutional study – in which we can potentially tease if one part of our protocol is more effective than any other."
The protocol should be replicable beyond Lancaster General Hospital, he said. "We think the approach is unique, but believe with further study we can show this can be applied at other institutions with equivalent successes."
Dr. Bradburn and Dr. Schulman reported no relevant conflicts of interest.
