Improved Outcomes in Elderly Trauma Patients with the Implementation of Two Innovative Geriatric-Specific Protocols – Final Report

ABSTRACTINTRODUCTIONElderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants. We hypothesized that both the HRGP and ACT would decrease mortality and complications in geriatric trauma patients.METHODSGeriatric (aged ≥65) blunt trauma patients presenting to our level II center from January 2000 to July 2016 were extracted from the trauma registry. DNR patients were excluded. The study period was divided into 3 phases: Phase 1) no PMGs in place (2000-January 2006); Phase 2) HRGP only (February 2006-February 2012); and Phase 3) HRGP + ACT (March 2012-July 2016). Multivariate logistic regression models assessed adjusted mortality and complications during these phases to quantify the impact of these protocols. Statistical significance was set at p

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