Routine geriatric consults in older trauma patients are associated with improved outcomes, researchers report.
Studies of older patients with orthopedic injuries have shown geriatric consultation to result in lower mortality, reduced readmissions, fewer complications, and shorter lengths of stay. Whether these benefits accrue in other settings has been unclear.
Dr. Olubode A. Olufajo and colleagues, from Brigham and Women’s Hospital, Boston, assessed the processes of care and outcomes among older patients admitted to the trauma service before (n=215) and after (n=191) geriatric consults were mandated for all trauma patients 70 years old or older.
The proportion of patients who were do not resuscitate/do not intubate increased from 10.23 percent before geriatric consults became mandatory to 38.22 percent after implementation, according to a Journal of the American College of Surgeons online report.
Referrals for formal cognitive evaluation increased from 2.33 percent before to 14.21 percent after implementation (p<0.01).
There were also decreases in in-hospital mortality (from 9.30 percent to 5.24 percent), 30-day mortality (from 11.63 percent to 6.81 percent), and intensive care unit readmission (from 8.26 percent to 1.96 percent), but these changes fell short of statistical significance.
Hospital length of stay and 30-day hospital readmissions did not differ between the two groups.
“This study highlights the potential benefits of mandatory geriatric consults in routine patient care,” the authors conclude. “Therefore, trauma services should consider adopting this approach to the care of their older patients.”
Dr. Olufajo did not respond to a request for comments.
The authors reported no funding or disclosures.