Elderly trauma patients show lower delirium risk, discharge

A new care service where patients older than 60 years are seen by a geriatric team member within 72 hours of a hospital stay lowers the risk of delirium and discharge to a long-term care facility, according to Toronto researchers.

“Older patients admitted to trauma are complex,” Camilla L. Wong MD, MHSc, lead author and geriatrician in the trauma unit at St. Michael’s Hospital in Toronto, stated in a press release. “They often have pre-existing health issues, resulting in more in-hospital complications and medical consultations. The traditional model addressed these later, but we felt it was necessary to involve the geriatric team at an earlier point to make sure we are providing the best possible care.”

Wong and colleagues examined 238 patients before and 248 patients after instituting the Geriatric Trauma Consultation Service. After the hospital instituted the service, delirium complications in the patients decreased from 50.5% to 40.9%, according to the abstract. Patient discharge to long-term care facilities also decreased from 6.5% before the service to 1.7% after the service.

“Seeing a reduction in the risk of developing delirium for these patients was a significant finding,” Wong said. “Developing delirium in hospital has been associated with morbidity, longer length of hospital stay, increased hospital-acquired complications and permanent cognitive decline, such as developing dementia.”

She added, “In older patients, there is a lot more to consider than just treating their traumatic injuries. More than 30% of the patients who come to the trauma unit are 60 [years] and older so it is important we have programs like this to properly take into account all their needs.”

Reference:

Lenartowicz, M. Ann Surg. 2012;doi:10.1097/SLA.0b013e318270f27a.