Complications of elderly orthopaedic trauma: Relationship of age, marital status and skeletal injury to discharge disposition

Introduction: With increasing life expectancy, better medical technology and preventative care, older adults are the fastest growing population in the US. For the elderly, fractures are a leading cause of hospitalization and medical overhead. This study analyzes age, skeletal injury, and discharge disposition.

Methods: A three-year retrospective review of trauma data was conducted at a regional level I trauma center. 2,568 fracture patients were grouped into two age cohorts: <60 and >59 years old. Dependent variables include fracture type, length of stay, marital status, discharge disposition, and mechanism of injury. SPSS was used to calculate frequency tables, odds ratios, and Chi-square.

Results: Age distribution: 41% <60; 59% >59. 65% of fractures were fall-related. The most prevalent injury was femoral fracture (39%). 85% of femur fractures were in patients >59. Older patients were more likely to injure themselves falling than younger patients (OR=16.8, CI=3.7-20.6; p<0.001). Patients >59 were more likely to have pertrochanteric (hip) fractures than patients <60 (OR=14.9, CI=10.8-20.7 p<0.001). Older widowed patients were more likely to be discharged to rehabilitation or long-tem care facility (OR=2.6, CI=2.0-3.4; p<0.001) Older patients were at 15 fold greater odds of being discharged to rehabilitation or long-term care facility than patients <60 (OR=15.3, CI=12.6-18.6; p<0.001).

Conclusions: This study provides evidence that the elderly experience numerous skeletal fractures and are more likely to end up in rehabilitation and long-term care than their younger cohort. The socioeconomic toll of this trend has yet to be fully measured and is an important prevention and public health issue.