Outcomes Associated with Using the Identification of Seniors at Risk Score to Determine Geriatric Evaluations of Trauma Patients with Hip Fractures

Document Type

Conference Proceeding

Publication Date

4-2022

Publication Title

J Am Geriatric Soc

Abstract

Background: Falls contribute to hip fractures in older adults and can cause decline requiring increased levels of care. In 2013, a Level II Trauma center adopted the Identification of Seniors at Risk (ISAR) screening tool for patients older than 60 to capture the need for Geriatric evaluations. The purpose was to understand outcomes of older adults admitted with a hip fracture sustained after falling related to their ISAR score and before and after the implementation of the screening tool.

Methods: This was a retrospective program evaluation. Charts for patients older than 60, admitted for hip fracture to the trauma service during July 2014-June 2016 and January 2017- December 2019 were reviewed. Variables were described using means/standard deviations for continuous variables and counts/percentages for nominal data. Continuous variables that did not follow a normal distribution were described via medians and interquartile ranges. The two groups were compared with Student's t-Tests for continuous variables and Chi-squared tests for nominal variables. To evaluate variables related to each ISAR score the Kruskal-Wallis test was used. The p-value was adjusted as needed to conclude significance using Hochberg's adjustment.

Results: Ages varied between each ISAR score (p=0.0001) and there was a positive correlation with older age and increasing score. Other significant findings related to higher ISAR scores include increased length of stay (LOS) (p=0.012) and presence of hospice consults (p=0.034). No significant difference was observed in ISS, inpatient mortality, ICU LOS, or discharge to a SNF as it relates to each ISAR score. When comparing the pre to post group with Geriatric evaluations, there was an increase in age (p=0.026) and ISS (p=0.001), and no significant differences in LOS, ICU LOS, readmission rates, Hospice consults, or in-hospital mortality. In-hospital mortality and LOS down-trended in the post-group with Geriatric evaluation.

Conclusions: This study demonstrated outcomes for older adult Trauma patients who sustained a hip fracture related to their ISAR score and presence of a Geriatric evaluation. Further research can focus on other injuries, understanding the elements of the Geriatric evaluations, and the compliance to Geriatric recommendations.

Volume

70

Issue

Suppl 1

First Page

S73

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