Background The recent NOCA report highlights a significant portion of major trauma cases resulting from falls among older adults, who often face limited access to trauma centres and age-related biases in treatment. Existing protocols and services for older trauma patients are lacking. This study aimed to audit the incidence and outcomes of MTOA admitted under the non-trauma specialties at a Major Trauma Centre. Methods Data from handover documents between January 2019 and December 2023 were screened for cases of “older trauma” (patients >65 with new trauma injuries) and analysed using Microsoft Excel. Results Between 2019 and 2023, 992 older patients were admitted under non-trauma specialties, with a mean age of 83 years and a majority being female 73% (N=170). The mean length of stay was 14 days, with pelvis injuries being most common 31% (N=307). Falls from standing height accounted for 83% (N=823) of injuries. Only 28% (N=217) of patients at immediate risk of further fragility fractures received bone protection. Most patients were discharged home 49% (N=456), while 6% (N=55) were institutionalized. The total mortality rate in hospital was 7% (N=66). The total mortality at one year was 17% (N=121). The injury with the highest mortality in hospital 24% (N=21) and at one year 40% (N=35) was traumatic brain injuries. Conclusion This audit reveals disparities in trauma care for older patients, despite advances in the field. While initiatives like the hip fracture database have improved care for specific injuries, pathways for older trauma patients not requiring surgery are lacking. Given the excess morbidity and mortality among this population, establishing a Geriatric Trauma Service is imperative. This is in line with literature supporting the idea that older trauma patients demand specialist attention; they are not just older adults.

中文翻译：

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“为了照顾服务不足的人” MTC 非创伤专业入院的 M​​TOA 描述性分析


背景 NOCA 最近的报告强调了老年人跌倒造成的重大创伤病例的很大一部分，他们往往面临进入创伤中心的机会有限以及治疗中与年龄相关的偏见。缺乏针对老年创伤患者的现有方案和服务。本研究旨在审核重大创伤中心非创伤专业入院的 M​​TOA 的发生率和结果。方法 对 2019 年 1 月至 2023 年 12 月期间移交文件的数据进行筛查，以查找“老年创伤”病例（有新创伤的 >65 例患者），并使用 Microsoft Excel 进行分析。结果 2019 年至 2023 年间，非创伤专业收治了 992 名老年患者，平均年龄 83 岁，大多数为女性，占 73%（N=170）。平均住院时间为 14 天，其中骨盆损伤最常见，占 31% (N=307)。从站立高度跌落造成的伤害占 83% (N=823)。只有 28% (N=217) 面临进一步脆性骨折直接风险的患者接受了骨保护。大多数患者 49% (N=456) 出院回家，而 6% (N=55) 则被送往收容机构。住院总死亡率为7%（N=66）。一年内的总死亡率为 17% (N=121)。院内死亡率最高的损伤是创伤性脑损伤，为 24% (N=21)，一年后死亡率为 40% (N=35)。结论 尽管该领域取得了进展，但本次审计揭示了老年患者创伤护理方面的差异。虽然髋部骨折数据库等举措改善了对特定损伤的护理，但缺乏针对不需要手术的老年创伤患者的途径。鉴于该人群的发病率和死亡率过高，建立老年创伤服务势在必行。 这与支持老年创伤患者需要专家关注这一观点的文献是一致的；他们不仅仅是老年人。