Maryland Trauma Patients Over Age 65 Less Likely To Be Brought to Trauma Centers, Study Finds

Trauma patients over age 65 are less likely than younger patients to be taken to Maryland trauma centers, according to a report published Tuesday in the Archives of Surgery, the Baltimore Sun reports. For the study, researchers from Johns Hopkins University School of Medicine and Bloomberg School of Public Health, led by surgery professor David Chang, analyzed data taken from the Maryland Ambulance Information System for about 26,000 trauma patients in the state between 1995 and 2004. They also interviewed 166 emergency medical and trauma center personnel. Researchers found that 50% of patients older than 65 were not taken to trauma centers, compared with 18% of younger patients. Although the disparity was notable for patients older than 65, researchers found that it began at age 50, the Sun reports.

Researchers discovered through the interviews that lack of training, unfamiliarity with transportation protocol and possible age bias were the biggest factors in the discrepancy. Chang said, "We use the word bias in certain areas of our study. But we also talk about blind spots," adding, "People are operating on assumptions of what old is and what elderly patients need." Researchers found that in some cases, EMS workers reported not being welcomed by trauma officials when arriving with an elderly patient, and that younger trauma doctors might perceive an elderly patient's fall as "less exciting" than a gunshot wound, although the injuries can be equally severe, the Sun reports.

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Chang said, "Trauma is often seen as a disease of the young," but "that's changing. You have a fairly active aging population that is playing sports, being active and getting injured." Chang noted that by 2050, about 39% of trauma patients will be 65 or older. Robert Bass, executive director of the Maryland Institute of Emergency Medical Services, who helped analyze the report, said, "[W]e want to share [the results] with other states and EMS systems because if it's happening in Maryland, it's likely happening everywhere." According to the Sun, MIEMS in the past year included age as a factor in its guidelines for when to take patients to trauma centers after the change was advised by the American College of Surgeon's Committee on Trauma (Brewington, Baltimore Sun, 8/19).

An abstract of the study is available online.