This study was carried out to evaluate and quantify risk factors, mechanisms, and cost of traumatic injuries in Hawaii's elderly and to identify potential preventive strategies. A retrospective review of a prospective database of patients admitted to the only Trauma Center in the Pacific Basin, between January 2000 and December 2001, was conducted. Of 2634 trauma admissions, 11% were ≥65 years of age. Mechanisms of injury included falls, motor vehicle crashes (MVCs), pedestrians hit by automobiles, and miscellaneous causes. The incidence of elderly pedestrians hit by automobiles in Hawaii is higher than previously reported. Hospital mortality rate was highest for the pedestrian hit group, followed by falls, and then MVCs. The pedestrian hit group consumed the largest quantity of resources and MVCs the least. Given the high mortality rate and associated resource consumption in the pedestrian hit group, it would be appropriate to give priority to this group while developing preventive measures for this age group.
Gubler KD, Davis D., Koepsell T., Soderberg R., Maier RV, Rivara FPLong-term survival of the elderly trauma patients. Arch Surg . 1997;132:1010-1014.
2.
Schwab CW, Kauder DRTrauma in the geriatric patient. Arch Surg. 1992;127:701-706.
3.
Young L., Ahmad H.Trauma in the elderly: a new epidemic? Aust N Z J Surg. 1999;69:584-586.
4.
Ng W., Fujishima S., Suzuki M., et al. Characteristics of elderly patients presenting to the emergency department with injury. Keio J Med. 2002;51:11-16.
5.
Finelli FC, Jonsson J., Champion HR, Morelli S., Fouty WJA case control study for major trauma in geriatric patients. J Trauma. 1989;29:541-548.
6.
King MB, Tinetti MEFalls in community-dwelling older persons. J Am Geriatr Soc . 1995;43: 1146-1154.
7.
Oreskovich MR , Howard JD, Copass MK, Carrico CJGeriatric trauma: injury patterns and outcome . J Trauma. 1984 ;24:565-570.
8.
Osler T., Hales K., Baack B., His K., Pathak D., Demarest G.Trauma in the elderly. Am J Surg. 1988;156:537-543.
9.
Santora TA, Schinco MA, Trooskin SZManagement of trauma in the elderly patient. Surg Clin North Am. 1994;74:163-186.
10.
Smith DP, Enderson BL, Maull KITrauma in the elderly: determinations of outcome. South Med J. 1990;83:171-177.
11.
van der Sluis CK, Klasen HJ, Eisma WH, ten Duis HJMajor trauma in young and old: what is the difference. J Trauma. 1996;40:78-82.
Mathers CD, Loncar D.Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med.2006;3:e442.
14.
Bose A., Konradsen F., John J., Suganthy P., Muliyil J., Abraham S.Mortality rate and years of life lost from unintentional injury and suicide in south India. Trop Med Int Health. 2006;11: 1553-1556.
15.
Murlidhar V. , Roy N.Measuring trauma outcomes in India: an analysis based on TRISS methodology in a Mumbai university hospital. Injury. 2004 ;35:386-390.
16.
Garg N., Hyder AAExploring the relationship between development and road traffic injuries: a case study from India. Eur J Public Health. 2006;16:487-491.
17.
Yang BM, Kim J.Road traffic accidents and policy intervention in Korea. Inj Contr Saf Promot. 2003;10:89-94.
18.
Suriyawongpaisal P., Kanchanasut S.Road traffic injuries in Thailand: trends, selected underlying determinants and status of intervention. Inj Contr Saf Promot. 2003;10:95-104.
19.
Wang SY, Chi GB, Jing CX, Dong XM, Wu CP, Li LPTrends in road traffic crashes and associated injury and fatality in the People's Republic of China, 1951-1999. Inj Contr Saf Promot. 2003;10:83-87.
20.
Khan FM, Jawaid M., Chowan H., Luby S.Pedestrian environment and behavior in Karachi, Pakistan. Accid Anal Prev. 1999;31:335-339.
21.
Ghani E., Nadeem M., Bano A., Irshad S., Zaidi GI, Khaleeq-uz-Zaman.Road traffic accidents as a major contributor to neurosurgical mortality in adults . J Coll Physicians Surg Pak. 2003;13:143-145.
22.
Wong TW, Phoon WO, Lee J., Yiu IP, Fung KP, Smith G.Motorcycle traffic accidents and risk factors: a Singapore study. Asia Pac J Public Health. 1990;4:34-38.
23.
Wong E., Leong MK, Anantharaman V., Raman L., Wee KP, Chao TCRoad traffic accident mortality in Singapore. J Emerg Med . 2002;22:139-146.
24.
Roohi SA, Naicker AS, Shukur MH, Mohammad ARSpinal injuries in a level-one trauma centre: a demographic study . Med J Malaysia.2006;61(suppl A):30-35.
25.
Lin JW, Tsai SH, Tsai WC, et al. Survey of traumatic intracranial hemorrhage in Taiwan. Surg Neurol. 2006;66(suppl 2):S20-S25.
26.
Wu SI, Malison MDMotor vehicle injuries in Taiwan. Asia Pac J Public Health . 1990;4:72-75.
27.
Sugimoto K. , Aruga T., Hirata M., Shindo M.Geriatric trauma patients at a suburban level-I trauma center in Japan. Prehosp Disaster Med. 1999;14:186-190.
28.
Ezaki T., Yamada T., Yasuda M., et al. Geriatric patients presenting to the emergency department of a Japanese university hospital. Fukuoka Igaku Zasshi. 2006;97:269-276.
29.
Safih MS, Norton R., Rogers I., Gardener JP, Judson JAElderly trauma patients admitted to the intensive care unit are different from the younger population. N Z Med J. 1999 ;112:402-404.
30.
Hu SC, Yen D., Yu YC, Kao WF, Wang LMElderly use of the ED in an Asian metropolis. Am J Emerg Med . 1999;17:95-99.
31.
Fingerhut LA , Cox CS, Warner M.International comparative analysis of injury mortality: findings from the ICE on injury statistics. Adv Data. 1998;(303):1-20.
32.
Davis JW, Ross PD, Nevitt MC, Wasnich RDIncidence rates of falls among Japanese men and women living in Hawaii . J Clin Epidemiol. 1997;50:589-594.
33.
Chu LW, Chi I., Chiu AYY.Incidence and predictors of falls in the Chinese elderly. Ann Acad Med Singapore. 2005;34:60-72.
34.
Johnson SJFrequency and nature of falls among older women in India. Asia Pac J Public Health. 2006;18:56-61.
35.
Tinetti ME, Baker DI, McAvay G., et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med . 1994;331:821-827.
36.
Reinsch S., MacRae P., Lachenbruch PA, Tobis JSAttempts to prevent falls and injury: a prospective community study . Gerontologist. 1992;32:450-456.
37.
Karni A., Holtzman R., Bass T., et al. Traumatic head injury in the anticoagulated elderly patient: a lethal combination. Am Surg. 2001:67:1098-1100.
38.
Province MA , Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients: a preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques . JAMA. 1995;273:1341-1347.
39.
Wolf-Klein GP, Silverstone FA, Basavaraju N., Foley CJ, Pascaru A., Ma PHPrevention of falls in the elderly population . Arch Phys Med Rehabil. 1988;69:689-691.
40.
Wagner EH, LaCroix AZ, Grothaus L., et al. Preventing disability and falls in older adults: a population-based randomized trial. Am J Public Health. 1994 ;84:1800-1806.
41.
Knudson MM, Vassar MJ, Straus EM, Hammond JS, Campbell SDSurgeons and injury prevention: what you don't know can hurt you!J Am Coll Surg.2001;193:119-124.
42.
Champion HR, Copes WS, Boyer D., Flanagan ME, Bain L., Sacco WJMajor trauma in geriatric patients. Am J Public Health . 1989;79:1278-1282.
43.
Tornetta P. III, Mostafavi H., Riina J., et al. Morbidity and mortality in elderly trauma patients. J Trauma. 1999;46:702-706.
44.
Demetriades D. , Sava J., Alo K., et al. Old age as a criterion for trauma team activation. J Trauma. 2001;51:754-757.
45.
Li G., Baker S.A comparison of injury death rates in China and the United States, 1986. Am J Public Health.1991;81:605-609.
46.
Suzuki T., Kim H., Yoshida H., Ishizaki T.Randomized controlled trial of exercise intervention for the prevention of falls in community-dwelling elderly Japanese women. J Bone Miner Metab. 2004;22:602-611.
47.
Langlois JA, Smith GS, Baker SP, Langley JDInternational comparisons of injury mortality in the elderly: issues and differences between New Zealand and the United States. Int J Epidemiol . 1995;24:136-143.
48.
Yang L., Lam LT, Liu Y., Geng WK, Liu DCEpidemiological profile of mortality due to injuries in three cities in the Guangxi Provence, China. Accid Anal Prev. 2005;37:137-141.
49.
Yap LK, Au SY, Ang YH, Ee CHNursing home falls: a local perspective. Ann Acad Med Singapore . 2003;32:795-800.
50.
Lau G., Seow E., Lim ESA review of pedestrian fatalities in Singapore from 1990 to 1994. Ann Acad Med Singapore.1998;27:830-837.
51.
Battistella FD, Din AM, Perez L.Trauma patients 75 years and older: long term follow-up results justify aggressive management. J Trauma . 1998;44:618-624.
52.
Demaria EJ, Kenney PR, Merriam MA, Casanova LA, Gann DSAggressive trauma care benefits the elderly. J Trauma. 1987;27:1200-1206.
53.
Lee KK, Seow WT, Ng I.Demographic profiles of adult severe traumatic brain injury patients: implications for healthcare planning. Singapore Med J. 2006;47:31-36.
54.
Aoyagi K., Ross PD, Davis JW, Wasnich RD, Hayashi T., Takemoto T.Falls among community-dwelling elderly in Japan. J Bone Miner Res. 1998;13:1468-1474.
55.
Ding SL, Wang JD, Chen KTEpidemiologic analysis of 845 cases of pedestrian traffic injuries. Zhonghua Yi Xue Za Zhi.1994;53(6, suppl B):16-22.
56.
Covington DL , Maxwell JG, Clancy TVHospital resources used to treat the injured elderly at North Carolina trauma centers. J Am Geriatr Soc . 1993:41:847-852.
57.
Ross N., Timberlake GA, Rubino LJ, Kerbstein MDHigh cost of trauma care in the elderly. South Med J. 1989;82:857-859.
58.
Duperrex O. , Bunn F., Roberts I.Safety education of pedestrians for injury prevention: a systemic review of randomized controlled trials. BMJ. 2002;324(7346):1129-1133.
59.
Wong TWRoad traffic accidents in the elderly: a major cause of morbidity and mortality . Ann Acad Med Singapore. 1987 ;16:101-105.
60.
Wang Z., Jiang J.An overview of research advances in road traffic trauma in China. Traffic Inj Prev. 2003;4:9-16.
61.
Dandona R.Making road safety a public health concern for policy makers in India . Natl Med J India. 2006;19:126-133.
