Clinical Characteristics of Major Trauma in Older Adults at an Australian Level 1 Trauma Service: A 10‐Year Retrospective Review

BACKGROUND: A shift in the age profile of major trauma patients creates new challenges to trauma system design. Examining historical trends of major trauma in older people allows us to better plan for an effective trauma system. This study explores the clinical characteristics of older adult trauma cases presenting to a level one trauma center in Australia during the last 10 years. METHODS: This single-center retrospective observational study utilized data from the Western Australian State Trauma Registry. Patients aged 65 years and over with major trauma (ISS > 12) who presented to our center between 2014 and 2023 were included. RESULTS: 2549 patients met the inclusion criteria, with a mean age of 77 years and 63% of them were male. The number and the proportion of major trauma in older adults increased from 195 (21.1%) in 2014 to 324 (29%) in 2023. Falls from standing height were the most frequent mechanism of injury (44.1%). Injuries to head and neck were the most common serious injuries (60.4%). Significant differences were observed across age groups in injury mechanisms, interventions, discharge destination, and in-hospital mortality rates. CONCLUSION: Older trauma presentations at the State Trauma Referral Service have increased. This study highlights the changes in injury patterns, clinical outcomes, and trauma management in older adult major trauma cohort during the last 10 years. These data provide the basis for the ongoing, tailored, evolution of trauma services to cater to the patients it serves.