DOI: 10.5061/dryad.r4xgxd29s
title: The effect of geriatric comanagement (gc) in geriatric trauma patients treated in a level 1 trauma setting: a comparison of data before and after the implementation of a certified geriatric trauma center

description: NOTICE: The original data files published with this dataset have been
 removed due to non-compliance with Dryad guidelines for publishing human
 subjects data. ************** **Introduction: **Improvements in
 life expectancy imply that an increase of geriatric trauma patients
 occurs. These patients require special attention due to their multiple
 comorbidity issues. The aim of this study was to assess the impact of the
 implementation of geriatric comanagement (GC) on the allocation and
 clinical outcome of geriatric trauma patients. **Methods: **This
 observational cohort study aims to compare the demographic development and
 the clinical outcome in geriatric trauma patients (aged 70 years and
 older) before and after implementation of a certified geriatric trauma
 center (GC). Geriatric trauma patients admitted between January 1, 2010
 and December 31, 2010 were stratified to group pre-GC and admissions
 between January 1,  2018 and December 31, 2018 to Group post-GC.
 We excluded patients requiring end-of-life treatment and those who died
 within 24 h or due to severe traumatic brain injury. Outcome parameters
 included demographic changes, medical complexity (measured by American
 Society of Anaesthesiology Score (ASA) and Charlson Comorbidity Index
 (CCI)), in-hospital mortality and length of hospitalization.
 **Results: **This study includes 626 patients in Group pre-GC
 (mean age 80.3 ± 6.7 years) and 841 patients in Group post-GC (mean age
 81.1 ± 7.3 years). Group pre-GC included 244 (39.0%) males, group post-GC
 included 361 (42.9%) males. The mean CCI was 4.7 (± 1.8) points in pre-GC
 and 5.1 (± 2.0) points in post-GC (p &lt;0.001). In Group pre-GC, 100
 patients (16.0%) were stratified as ASA 1 compared with 47 patients (5.6%)
 in Group post-GC (p &lt;0.001). Group pre-GC had significantly less
 patients stratified as ASA 3 or higher (n = 235, 37.5%) compared with
 Group post-GC (n = 389, 46.3%, p &lt;0.001). Length of stay (LOS)
 decreased significantly from 10.4 (± 20.3) days in Group pre-GC to 7.9
 (±22.9) days in Group post-GC (p = 0.011). The 30-day mortality rate was
 comparable amongst these groups (pre-GC 8.8% vs. post-GC 8.9%).
 Conclusion: This study appears to support the implementation of a
 geriatric trauma center, as certain improvements in the patient care were
 found: Despite a higher CCI and a higher number of patients with higher
 ASA classifications, Hospital LOS, complication rates and mortality did
 were not increased after implementation of the CG. The increase in the
 case numbers supports the fact that a higher degree of specialization
 leads to a response by admitting physicians, as it exceeded the expectable
 trend of demographic ageing. We feel that a larger data base, hopefully in
 a multi center set up should be undertaken to verify these results.
description: # The effect of geriatric comanagement (gc) in geriatric trauma patients
 treated in a level 1 trauma setting: a comparison of data before and after
 the implementation of a certified geriatric trauma center Dataset DOI:
 [10.5061/dryad.0rxwdbsdk](10.5061/dryad.0rxwdbsdk) **NOTICE**: The
 original data files published with this dataset have been removed due to
 non-compliance with Dryad guidelines for publishing human subjects data.
 #### ## Human subjects data (Data has been removed from Dryad due to HSI
 issues.)