Identification of Seniors at Risk Score to Determine Geriatric Evaluations on Trauma Patients With Hip Fractures.

Abstract

Background: Trauma centers are confronted with rising numbers of geriatric trauma patients at high risk for adverse outcomes. Geriatric screening is advocated but not standardized within trauma centers.

Objective: This study aims to describe the impact of Identification of Seniors at Risk (ISAR) screening on patient outcomes and geriatric evaluations.

Methods: This study used a pre-/postdesign to assess the impact of ISAR screening on patient outcomes and geriatric evaluations in trauma patients 60 years and older, comparing the periods before (2014-2016) and after (2017-2019) screening implementation.

Results: Charts for 1,142 patients were reviewed. Comparing pre- to post-ISAR groups, the post-ISAR group with geriatric evaluations were older (M = 82.06, SD = 9.51 vs. M = 83.64, SD = 8.69; p = .026) with higher Injury Severity Scores (M = 9.22, SD = 0.69 vs. M = 9.38, SD = 0.92; p = .001). There was no significant difference in length of stay, intensive care unit length of stay, readmission rate, hospice consults, or inhospital mortality. Inhospital mortality (n = 8/380, 2.11% vs. n = 4/434, 0.92%) and length of stay in hours (M = 136.49, SD = 67.09 vs. M = 132.53, SD = 69.06) down-trended in the postgroup with geriatric evaluation.

Conclusion: Resources and care coordination efforts can be directed toward specific geriatric screening scores to achieve optimal outcomes. Varying results were found related to outcomes of geriatric evaluations prompting future research.