Low Baseline (Pre-Injury) Blood Pressure Predicts Inpatient Mortality in Elderly Trauma Patients: A Bi-Institutional Study.

Objective: The relationship between baseline (ie. pre-injury) blood pressure and trauma outcomes in elderly patients is unknown. We therefore aimed to identify the independent impact of baseline systolic blood pressure (SBP) on inpatient mortality amongst elderly trauma patients. Methods: The 2004-2014 trauma registries of two Level I Trauma Centers were linked to electronic health records then reviewed to identify patients >=65 years old with available baseline vital signs. Baseline SBP was defined as mean outpatient SBP within two years prior to injury. Trauma SBP was defined as first SBP reading after presentation for trauma. Baseline and Trauma SBP were classified as Low (=140mmHg). Logistic multivariable regression models were constructed to assess the independent impact of Baseline SBP on inpatient mortality, controlling for demographics, comorbidities, injury mechanism/severity, and Trauma SBP. Results: Of 37,494 patients, 4,233 met inclusion criteria. Median age was 81 years; 63.6% were female. Mortality was 5.39%. In unadjusted analyses, mortality rates were 11.01%, 5.28%, and 4.52% in the Low, Normal, and High Baseline SBP groups, respectively (p=0.001). In multivariable analyses, patients with Low Baseline SBP had significantly increased mortality risk [OR 3.19 (95%CI 1.62-6.26), p=0.001] compared to patients with Normal Baseline SBP, in particular when they presented with Low Trauma SBP (

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