Mortality is predicted by Comorbidity Polypharmacy score but not Charlson Comorbidity Index in geriatric trauma patients

Am J Surg. 2018 Jul;216(1):42-45. doi: 10.1016/j.amjsurg.2017.09.011. Epub 2017 Sep 19.

Abstract

Background: Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered.

Methods: 446 older trauma patients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS).

Results: CCI and CPS were associated with HLOS in patients <65. In patients aged 45-65, only CPS was associated with HLOS. CPS was inversely associated with in-hospital mortality in patients <65, but not patients aged 45-65. CCI score was not associated with in-hospital mortality in either group.

Conclusion: Increased CCI and CPS were associated with increased HLOS. In patients over 65, increased CPS was associated with decreased mortality. This could be due to return toward physiologic normalcy in treated patients not seen in their peers with undiagnosed or untreated comorbidities.

Keywords: Geriatric trauma; Outcomes; Scoring systems.

MeSH terms

  • Aged
  • Comorbidity / trends
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / methods*
  • Hospital Mortality / trends
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • New York / epidemiology
  • Polypharmacy*
  • Prognosis
  • Retrospective Studies
  • Trauma Centers / statistics & numerical data*
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / therapy