Elderly Patients Incur Additional Injuries in Care Facilities Following Trauma Admissions

Background Little is known about where elderly trauma injuries occur and the impact of elderly care environment on injuries. We describe differences in elderly trauma patients’ injury prevalence, patterns, and trauma recidivism according to their care environment. Methods A retrospective, observational study of trauma patients (n = 649). We performed multivariable logistic regression modeling to calculate the odds of returning to the hospital within 30 days for a new injury after controls. We repeated our analyses with age subgroups (65-84 vs 85 and older). We graphically analyzed the path of our patient population from their initial encounter through recidivism with a Sankey diagram. Results Patients who come from an institutional setting are more likely to return to the hospital within 30 days after controls, but this is statistically insignificant (aOR: 1.82, P = .064). Elderly trauma patients coming from home (aOR: .94, P = .828) or who are injured in a public place (aOR: .52, P = .117) are less likely to recidivate after controls, but these proportions are not statistically significant. Patients who come from an institutional setting and are aged 65-84 are over three times more likely to return to the hospital within 30 days than same age patients injured at home or in public, after controls (aOR: 3.06, P = .008), however, this subgroup finding warrants caution and future prospective study. Discussion Most elderly trauma patients initially present from home, but elderly trauma recidivists are most likely to return from institutional settings. Trauma care decisions can benefit from an awareness of the elderly patient’s injury environment in preventing further injury.