The effect of traumatic head injuries on the outcome of middle-aged and geriatric orthopedic trauma patients

Authors

Rachel Ranson, NYU Langone Orthopaedic Hospital, New York, NY, United States; The George Washington University Hospital, Washington, DC, United States. Electronic address: rachelannranson@gmail.com.
Garrett W. Esper, NYU Langone Orthopaedic Hospital, New York, NY, United States.
Robert Woodruff, Campbell University School of Osteopathic Medicine, Lillington, NC, United States.
Sara J. Solasz, NYU Langone Orthopaedic Hospital, New York, NY, United States.
Kenneth A. Egol, NYU Langone Orthopaedic Hospital, New York, NY, United States; Jamaica Hospital Medical Center, 8900 Van Wyck Expy, Queens, NY 11418, United States.
Sanjit R. Konda, NYU Langone Orthopaedic Hospital, New York, NY, United States; Jamaica Hospital Medical Center, 8900 Van Wyck Expy, Queens, NY 11418, United States.

Document Type

Journal Article

Publication Date

3-1-2024

Journal

Injury

Volume

55

Issue

3

DOI

10.1016/j.injury.2023.111299

Keywords

Abbreviated injury score; Complication; Geriatric; Head injury; Outcomes; Traumatic

Abstract

BACKGROUND: The purpose of this study is to characterize the effects of head injuries amongst the middle-aged and geriatric populations on hospital quality measures, costs, and outcomes in an orthopedic trauma setting. METHODS: Patients with head and orthopedic injuries aged >55 treated at an academic medical center from October 2014-April 2021 were reviewed for their Abbreviated Injury Score for Head and Neck (AIS-H), baseline demographics, injury characteristics, hospital quality measures and outcomes. Univariate comparative analyses were conducted across AIS-H groups with additional regression analyses controlling for confounding variables. All statistical analyses were conducted with a Bonferroni adjusted alpha. RESULTS: A total of 1,051 patients were included. The mean age was 74 years, and median AIS-H score was 2 (range 1-6). While outcomes worsened and costs increased as AIS-H scores increased, the most drastic (and clinically relevant) rise occurs between scores 2-3. Patients who sustained a head injury warranting an AIS-H score of 3 experienced a significantly higher rate of major complications, need for ICU admission, inpatient and 1-year mortality with longer lengths of stay and higher total costs despite no differences in demographics or injury characteristics. Regression analysis found a higher AIS-H score was independently associated with greater mortality risk. CONCLUSION: AIS-H scores >2 correlate with significantly worse outcomes and higher hospital costs. Concomitant head injuries impact both outcomes and direct variable costs for middle-aged and geriatric orthopedic trauma patients. Clinicians, hospitals, and payers should consider the significant effect of head injuries on the hospitalization of these patients.

APA Citation

Ranson, Rachel; Esper, Garrett W.; Woodruff, Robert; Solasz, Sara J.; Egol, Kenneth A.; and Konda, Sanjit R., "The effect of traumatic head injuries on the outcome of middle-aged and geriatric orthopedic trauma patients" (2024). GW Authored Works. Paper 4628.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4628

Department

School of Medicine and Health Sciences Resident Works