Injury profiles and clinical management of older patients with major trauma

Objectives This study aimed to characterise the most common injury profiles and interventions in older major trauma patients, and how they change with age. Methods This is a retrospective review of interventions, injury profiles and outcomes of major trauma patients aged 65 years and older from 2007 to 2018, using data from the Victorian State Trauma Registry. A latent class analysis (LCA) was used to identify homogenous injury groups. Results The LCA identified five injury profiles: isolated head injury; chest/upper limb injuries; multi-trauma; isolated spine; and head/chest/upper limb. Among 10,001 patients, 50% had an isolated head injury, and 83% of patients received definitive treatment at a major trauma centre. 50% of patients received a surgical or non-surgical intervention, and 36% underwent surgery. These proportions declined with increasing age. Conclusions Older patients with major trauma are a heterogeneous group, whose mechanisms and patterns of injury, and clinical management change with increasing age.