Explaining the Difference in the Triage Rate of the Elderly: Are they Undertriaged or Not?
Etienne E Pracht*, Barbara Langland-Orban, David Ciesla, Joseph J Tepas and Lewis Flint
University of South Florida, Tampa, FL, USA
- *Corresponding Author:
- Etienne E Pracht
Associate Professor, Ph.D
University of South Florida
Health Policy and Management
13201 Bruce B Downs Blvd
MDC 56, Tampa, FL 33612, USA
Tel: 813 974 7609
Fax: 813 974 6741
E-mail: [email protected]sf.edu
Received Date: July 22, 2014; Accepted Date: August 08, 2014; Published Date: August 15, 2014
Citation: Pracht EE, Langland-Orban B, Ciesla D, Tepas JJ, Flint L (2014) Explaining the Difference in the Triage Rate of the Elderly: Are they Undertriaged or Not? . Emerg Med (Los Angel) 4:212. doi:10.4172/2165-7548.1000212
Copyright: © 2014 Pracht EE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
In Florida, the percent of injured elderly trauma patients with ICISS < 0.85 who were transported to a designated trauma center (DTC) was only 47.9 in 2013, which was about half the triage rate of non-elderly adults. This present analysis used Florida hospital discharge data to examine the difference in these triage rates by analyzing injury type, severity, and mechanism, distance to a DTC, and severity of comorbidities. Falls were the largest mechanism of injury among severely injured elderly (72.9 percent) yet had the lowest triage rate to DTCs (33.0 percent) among injury mechanism categories. In contrast, motor vehicle accidents (MVAs) were the most frequent for non-elderly adults (54.9 percent), which were associated with relatively high triage rates for both severely injured non-elderly and elderly (88.4 and 70.9, respectively). The severity of comorbid conditions may explain why severely injured elderly patients are less likely to be transported to a DTC. The severity of comorbidities among the elderly had a greater association with mortality than the ICISS, creating a need for paramedics to determine whether the DTC or closest hospital is the better alternative. The elderly have equal geographic access to trauma centers in Florida; however, they are less likely to use them, particularly for ground level falls, which often do not require surgery.