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J Emerg Trauma Shock. 2019 Jul-Sep;12(3):192-197. doi: 10.4103/JETS.JETS_145_18.

A Novel Risk Score to Predict Post-Trauma Mortality in Nonagenarians.

Author information

1
Department of Surgery, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York, USA.
2
School of Medicine, St. George's University, Grenada, West Indies, Grenada.
3
George Washington University, Washington, DC, USA.
4
Department of Surgery, NYU Brooklyn Hospital, Brooklyn, New York, USA.

Abstract

Background:

Nonagenarians represent a rapidly growing age group who often have functional limitations and multiple comorbidities, predisposing them to trauma.

Aims:

The purpose of this study was to identify patient characteristics, hospital complications, and comorbidities that predict in-hospital mortality in the nonagenarian population following trauma. We also sought to create a scoring system using these variables.

Settings and Design:

This study was a retrospective chart review.

Methods:

We reviewed the medical records of 548 nonagenarian trauma patients admitted to two Level I trauma centers from 2006 to 2015. Statistical analysis was performed using logistic regression and a machine learning model, which calculated significant variables and computed a scoring system.

Results:

The in-hospital mortality rate was 7.1% (n = 39). Significant predictors of mortality were cardiac comorbidity, neuro-concussion, New Injury Severity Score (ISS) 16+, striking an object, ISS 25-75, and pulmonary and cardiac complications. Significant variables were assigned a numeric value. A score of 5+ carried a 41.1% mortality risk, 79% sensitivity, and 91% specificity. A score of 10+ had an associated 81.8% mortality risk with 31% specificity and 99% sensitivity.

Conclusions:

Our findings identified reliable predictors of mortality in nonagenarian population posttrauma. The scoring system performs with good specificity and sensitivity and incrementally correlates with mortality risk.

KEYWORDS:

Mortality risk; nonagenarian; trauma

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