UMEM Educational Pearls

Category: Trauma

Title: Use of hospice for discharge in geriatric trauma patients

Keywords: Geriatric trauma, outcome, hospice (PubMed Search)

Posted: 3/17/2024 by Robert Flint, MD (Updated: 6/13/2024)
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This was a database study of nearly 2 million trauma patients over age 65 who were discharged looking at all levels of trauma centers. The authors found:

“Dominance analysis showed that proportion of patients with Injury Severity Score of >15 contributed most to explaining hospice utilization rates (3.2%) followed by trauma center level (2.3%), proportion White(1.9%), proportion female (1.5%), and urban/rural setting (1.4%).”

 Level one centers had the lowest level of discharge to hospice. The authors felt: “As the population ages, accurate assessment of geriatric trauma outcomes becomes more critical. Further studies are needed to evaluate the optimal utilization of hospice in end-of-life decision making for geriatric trauma.”

References

Variation in hospice use among trauma centers may impact analysis of geriatric trauma outcomes: An analysis of 1,961,228 Centers for Medicare and Medicaid Services hospitalizations from 2,317 facilities

Fakhry, Samir M. MD, FACS; Shen, Yan PhD; Wyse, Ransom J. MPH; Garland, Jeneva M. PharmD; Watts, Dorraine D. PhD

Journal of Trauma and Acute Care Surgery 94(4):p 554-561, April 2023. | DOI: 10.1097/TA.0000000000003883