Impact of pre-existing medical conditions on mortality in geriatric trauma: a nationwide study in Japan

Kenichiro Ishida; Yusuke Katayama; Tetsuhisa Kitamura; Tomoya Hirose; Masahiro Ojima; Shunichiro Nakao; Jotaro Tachino; Takeyuki Kiguchi; Kosuke Kiyohara; Jun Oda; Mitsuo Ohnishi

doi:10.1007/s00068-024-02570-3

Impact of pre-existing medical conditions on mortality in geriatric trauma: a nationwide study in Japan

Eur J Trauma Emerg Surg. 2024 Jun 18. doi: 10.1007/s00068-024-02570-3. Online ahead of print.

Authors

Affiliations

¹ Department of Acute Medicine and Critical Care Medical Center, NHO Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, Japan. kenichiro1224@gmail.com.
² Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
³ Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
⁴ Department of Acute Medicine and Critical Care Medical Center, NHO Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, Japan.
⁵ Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan.
⁶ Kyoto University Health Service, Kyoto, Japan.
⁷ Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan.

PMID: 38888791
DOI: 10.1007/s00068-024-02570-3

Abstract

Purpose: To investigate the relationship between pre-existing medical conditions and outcomes in elderly trauma patients in Japan.

Methods: This multicenter observational study utilized data from the Japan Trauma Data Bank (JTDB) from 2019 to 2020. The primary outcome was in-hospital mortality. Factors associated with in-hospital mortality were identified using multivariate logistic regression analysis, from which adjusted odds ratios (AOR) and 95% confidence intervals (CI) were determined.

Results: Of the participants during the study period, 19,598 patients were included in the analysis. Among the pre-existing medical conditions, moderate or severe liver disease showed the strongest positive association with in-hospital mortality (AOR: 7.087, 95% CI: 3.194-15.722), followed by multiple malignancies (AOR: 3.490, 95% CI: 1.046-11.641), congestive heart failure (AOR: 2.572, 95% CI: 1.920-3.445), and moderate or severe renal disease (AOR: 2.256, 95% CI: 1.584-3.215).

Conclusion: Data from JTDB suggests that pre-existing conditions like moderate or severe liver disease, congestive heart failure, and moderate or severe renal disease in elderly trauma patients are positively correlated with in-hospital mortality.

Keywords: Elderly; JTDB; Mortality; Pre-existing medical conditions; Trauma.