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Excerpt
Methods: All patients 15 years or greater who sustained pedestrian vs auto type injury from a level I trauma center registry over the past three years were reviewed. Elderly patients(60 yrs or greater) were selected for analysis. Chi square test was used to test significance at.01 level.
Results: A total of 747 adult patients including 207 patients >60 yrs of age arrived at our center after being struck by vehicles. Of the elderly subgroup, 42 arrived brain dead or in cardiac arrest. Of the 165 to survive resuscitation, 50% were sent to ICU. 28% to OR, and 22% to the ward. (Table 1)
By anatomic area, 28% suffered head trauma, 49% extremity/pelvic trauma, 14% chest trauma, 7% abdominal trauma, and 6% spinal trauma. Injuries were most common on Monday, Tuesday and Friday and least common on Sunday. Nearly one third occurred between the hours of 5pm and 9pm. Mean patient charge was $71,500 +/- 101,525 (median charge was $29,570). Total cost to this cohort was 14.6 million dollars.
Conclusions: Elderly victims of auto-pedestrian trauma are often significantly injured. They are likely to be treated in an ICU setting at significant cost and continue to experience high mortality rates. They have twice the death rate of our non-elderly adult population and triple the death rate of previously reported smaller series. Injury prevention measures may be beneficial in this extremely vulnerable population.
