Table 1.
Characteristics of injured older adults transported by emergency medical services (n = 5,021).
| Demographics: | ||
| Mean – age | 81.5 years | |
| 65 - 74 years | 1,256 | (25.0%) |
| 75 – 84 years | 1,624 | (32.3%) |
| 85 – 94 years | 1,871 | (37.3%) |
| ≥ 95 years | 270 | (5.4%) |
| Women | 3,373 | (67.2%) |
| Urban county | 4,826 | (96.1%) |
| Rural county | 195 | (3.9%) |
| Pre-911 comorbidities: | ||
| Myocardial infarction | 1,822 | (36.3%) |
| Congestive heart failure | 1,594 | (31.8%) |
| Dementia | 1,516 | (30.2%) |
| Diabetes | 1,464 | (29.2%) |
| Chronic renal failure | 1,445 | (28.8%) |
| COPD | 1,429 | (28.5%) |
| Cerebrovascular disease | 1,252 | (24.9%) |
| Peripheral vascular disease | 1,008 | (20.1%) |
| Cancer | 1,027 | (20.5%) |
| Rheumatoid arthritis | 283 | (5.6%) |
| Ulcers | 116 | (2.3%) |
| Paralysis | 114 | (2.3%) |
| Liver disease | 59 | (1.2%) |
| Mean - total count of comorbidities | 2.6 | (range 0 – 10) |
| Pre-injury anti-coagulation use (among 2,639 with known medication data)*: | ||
| Any | 400 | (15.2%) |
| Warfarin | 385 | (14.6%) |
| Non-warfarin anti-coagulants (enoxaparin, rivaroxaban, dabigatran, dalteparin, and fondaparinux) | 33 | (1.3%) |
| Out-of-hospital triage, physiology and procedures: | ||
| Met ≥ 1 current field triage criteria, per EMS | 583 | (11.6%) |
| SBP ≤ 110 mmHg | 503 | (10.0%) |
| SBP ≥ 200 mmHg | 193 | (3.8%) |
| GCS ≤ 8 | 22 | (0.4%) |
| GCS 9 – 12 | 93 | (1.8%) |
| GCS 13 – 15 | 4,906 | (97.7%) |
| Respiratory rate ≤ 10 or ≥ 24 breaths/minute | 288 | (5.7%) |
| Heart rate ≤ 60 or ≥ 110 beats/minute | 631 | (12.6%) |
| Assisted ventilation (bag-valve mask ventilation, intubation, supraglottic airway) | 29 | (0.6%) |
| Intravenous or intraosseus line | 889 | (17.7%) |
| Mechanism of Injury | ||
| Fall | 4,177 | (83.2%) |
| Motor vehicle crash | 284 | (5.7%) |
| Motor vehicle vs. pedestrian | 120 | (2.4%) |
| Penetrating injury (gunshot wound or stabbing) | 44 | (0.9%) |
| Other | 397 | (7.9%) |
| Initial hospital and subsequent inter-hospital transfers: | ||
| Level I | 427 | (8.5%) |
| Level II | 376 | (7.5%) |
| Level III | 1,056 | (21.0%) |
| Level IV | 781 | (15.6%) |
| Level V | 59 | (1.2%) |
| Non-trauma hospital | 2,322 | (46.3%) |
| Inter-hospital transfer | 434 | (8.7%) |
| Injury severity and injury patterns: | ||
| Mean ISS | 6.6 | |
| ISS 0 – 8 | 3,117 | (62.1%) |
| ISS 9 – 15 | 1,656 | (33.0%) |
| ISS 16 – 24 | 212 | (4.2%) |
| ISS > 24 | 36 | (0.7%) |
| Head AIS ≥ 3 | 243 | (4.9%) |
| Chest AIS ≥ 3 | 137 | (2.7%) |
| Abdominal-pelvic AIS ≥ 3 | 86 | (1.7%) |
| Extremity AIS ≥ 3 | 819 | (16.3%) |
| Hospital interventions: | ||
| Major surgery – non-orthopedic | 101 | (2.0%) |
| Orthopedic surgery | 808 | (16.1%) |
| Packed red blood cell transfusion (any) | 358 | (7.1%) |
| Cardiac procedures | 31 | (0.6%) |
| Outcomes: | ||
| 30-day mortality | 234 | (4.7%) |
| 90-day mortality | 458 | (9.1%) |
| 1-year mortality | 1,047 | (20.9%) |
*
There were 2,639 patients with Medicare Part D records for medication use within 90 days prior to 911 contact; 18 patients filled more than one anticoagulation medication during this time period. EMS = emergency medical services; SBP = systolic blood pressure: GCS = Glasgow Coma Scale score; ISS = Injury Severity Score; AIS = Abbreviated Injury Scale score.