Mortality and cost outcomes of elderly trauma patients admitted to intensive care and the general wards of an Australian tertiary referral hospital

COPYRIGHT 2009 Australian Society of AnaesthetistsMortality and cost outcomes of elderly intensive care unit (ICU) trauma patients were characterised in a retrospective cohort study from an Australian tertiary ICU Trauma patients admitted between January 2000 and December 2005 were grouped into three major age categories: aged > or =65 years admitted into ICU (n = 272); aged -65 years admitted into general ward (n = 610) and aged or = 65 years, ventilated) were: ICU or = 65 not-ventilated (OR 0.061) and ward > or = 65 (OR 0.086); increasing injury severity score and increased Charlson comorbidity index of 1 and 2, compared with zero (OR 2.21 [1.40 to 3.48] and OR 2.57 [1.45 to 4.55]). The raw mean daily ICU and hospital costs in A$2005 (US$) for age or = 65 to ICU, and > or = 65 to the ward were; for year 2000: ICU, $2717 (1462) and$2777 (1494); hospital, $1837 (988) and$1590 (855); ward $933 (502); for year 2005: ICU,$3202 (2393) and $3086 (2307); hospital,$1938 (1449) and $1914 (1431); ward$1180 (882). Cost increments were predicted by age < or = 65 and ICU admission, increasing injury severity score, mechanical ventilation, Charlson comorbidity index increments and hospital survival. Mortality cost-effect was estimated at -63% by least squares regression and -82% by treatment-effects regression model. Patient demographic factors, injury severity and its consequences predict both cost and survival in trauma. The cost mortality effect was biased upwards by conventional least squares regression estimation.L.Y.L. Chan, J.L. Moran, C. Clarke, J. Martin and P.J. Solomo