Diagnostic Accuracy and Risk Stratification of a Trauma Risk Assessment Tool Among those with Fall Injuries

Abstract

AbstractAimThe Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is an injury risk-triage tool. This study aims to validate the STTGMA’s accuracy in predicting fall-related mortality among geriatric trauma patients.MethodsUsing a retrospective cohort design, we selected 5,791 geriatric trauma patients (aged 55 years and older) from a single institutional trauma database (2017-2021). The outcome variable was fatal fall injury, measured as a binary variable. The predictor variable was the STTGMA score, measured as a continuous variable and a four-level categorical variable. We report the predictive accuracy (95% confidence interval (CI)) of the STTGMA. We further assessed the relationship between the STTGMA risk categories and hospital length of stay and time-to-death by performing multivariable quantile regression and time-varying Cox proportional hazard analyses, respectively.ResultsA total of 122 patients (2.1%) died during admission and the median hospital length of stay was 2 days. STTGMA exhibited 84% (95% CI: 75.6 – 92.0) accuracy in predicting in-hospital fall-related mortality. Compared to the minimal risk category, geriatric trauma patients classified as low, moderate, and high risks each had significantly longer hospital stays and adjusted mortality risks, in a dose-response pattern.ConclusionSTTGMA can accurately predict in-hospital mortality and risk-stratify the length of stay and the time to death among geriatric patients with fall injuries.