Hospital experience with geriatric trauma impacts long-term survival

Background: Hospital experience measured by geriatric trauma proportion (GTP) is associated with in-hospital mortality among geriatric patients. Our goal was to determine the impact of GTP on long-term survival among older trauma patients. Methods: This was a retrospective analysis of Medicare inpatient claims (2014-2015) of geriatric trauma patients admitted in Florida. GTP was calculated by dividing the number of geriatric trauma patients by the overall adult trauma volume in each hospital. Hospitals were then categorized into tertiles of GTP. Our main outcome was mortality at 30, 90, 180, and 365 days. Multivariable regression was performed to identify the association between GTP and long-term survival. Results: We included 65,763 geriatric trauma patients. As compared with hospitals in the lowest tertile, patients treated at the highest tertile were associated with lower mortality at 90 days (OR 0.90, 95%CI 0.82-0.98), 180 days (OR 0.90, 95%CI 0.83-0.97), and 365 days (OR 0.91, 95%CI 0.85-0.98). Conclusions: Higher GTP is associated with improved long-term outcomes. However, mortality following trauma among geriatric patients continues to increase for 12 months.