Older Patients Less Likely to Be Taken to Trauma Center

Rate of 'undertriage' in Maryland increased at age 50, became even more common at age 70
By Eric Metcalf
HealthDay Reporter

TUESDAY, Aug. 19 (HealthDay News) -- Emergency medical service providers are less likely to transport elderly trauma patients to a designated trauma center than younger patients, according to research published in the August issue of the Archives of Surgery.

David C. Chang, Ph.D., of the Johns Hopkins School of Medicine in Baltimore, and colleagues analyzed data from 26,565 patients who met American College of Surgeons criteria for trauma and were declared to be priority I by emergency medical services personnel. Undertriage was defined as a trauma patient not being transported to a designated Maryland trauma center.

The rate of undertriage was significantly higher in those age 65 and older than in younger patients, the investigators found. The researchers report that the decrease in trauma center transports began at the age of 50, with an odds ratio of transport of 0.67 for those aged 50 to 69 and an odds ratio of 0.45 for those 70 or older, compared to those younger than 50. In a follow-up survey of 166 emergency medical service and trauma center personnel, participants cited inadequate training as the top explanation for undertriage.

"The problem of age bias raised in this study may negate efforts to improve clinical care for elderly trauma patients within trauma centers if the system as a whole does not function properly and deliver patients appropriately to needed resources. However, it may be difficult to change attitudes of age bias and may require a broad societal campaign," the authors write.

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