Using geriatrics consultations for hospitalized older adults admitted for a trauma is associated with lower death and hospital readmissions. But data also showed the consultations are linked to longer hospital stays and higher rates of discharge to skilled nursing facilities, the authors wrote. The study was published Monday in the Journal of the American Geriatrics Society.
The authors want to further explore opportunities to reduce higher discharge rates to SNfs as well as longer hospital stays associated with geriatrics consultations. Also, more research is needed to assess the optimal criteria for geriatrics consultations, and the value in other hospitalized non-trauma older adults, the report said.
Older adults presenting with trauma have worse outcomes than younger adults. The researchers started providing geriatrics consultations to older adults when they were admitted to the trauma service at Mayo Clinic Hospital-Rochester.
As a result, they looked at data from people at their level 1 trauma center. The team compared data on 2,544 people who received geriatric consultations from 2016 to 2022 (the cohort study) to those who had any service during the same period. The team then compared data from 1,968 people who received geriatric consultations from 2016 to 2022 to people who didn’t have consultations from 2011 to 2015 and were brought to the trauma unit (this was the pre-post study). The average age of people was 80.6 years old in the pre-post study; it was 81.9 years old in the cohort study.
People who received geriatric consultations had higher injury severity scores and higher rates of being admitted to the intensive care unit, but delirium occurrence was lower in that group. Also, people who received the consultations died less in the hospital compared to controls, and had longer hospital stays. Older adults who participated in consultations at lower 30- and 90-day mortality. Similar trends were noted in the pre-post study.
Overall, having the consultations during a trauma resulted in reduced mortality and a trend toward lower readmission rates but was associated with increased length of stay and higher rates of discharge to skilled facilities, the authors wrote.
