Trauma Surgery & Acute Care Open (Jul 2024)

Geriatric trauma triage: optimizing systems for older adults—a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee

  • Bellal Joseph,
  • Vanessa P Ho,
  • Nasim Ahmed,
  • Tasce Bongiovanni,
  • Kartik Prabhakaran,
  • Asanthi Ratnasekera,
  • Sasha D Adams,
  • Joseph Posluszny,
  • Jody Digiacomo,
  • Milad Behbahaninia,
  • Melissa Hornor,
  • Jennifer Knight-Davis,
  • Tanya Egodage,
  • Elisabeth Swezey,
  • Adin Tyler Putnam,
  • Caitlin Cohan

DOI
https://doi.org/10.1136/tsaco-2024-001395
Journal volume & issue
Vol. 9, no. 1

Abstract

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Background Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.Methods We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older patient, evaluating existing literature and guidelines. Opportunities for improvement or standardization were identified.Results Opportunities for improved geriatric trauma triage exist in the pre-hospital setting, in the trauma bay, and continue after admission. They may include physiologic criteria, biochemical markers, radiologic criteria and even age. Recent Trauma Quality Improvement Program (TQIP) Best Practices Guidelines for Geriatric Trauma Management published in 2024 support these findings.Conclusion Trauma systems must adjust to provide optimal care for older adults. Further investigation is required to provide pertinent guidance.