Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025
Undertriage in geriatric trauma: insights from a multicentre cohort study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Factors Influencing Operational Delays in Prehospital Trauma Interventions: Evidence from a Romanian Cohort.Medicina (Kaunas, Lithuania) · 2026Article
- Trauma as a critical condition in the very old: assessment, care pathways and outcome differences.European geriatric medicine · 2026Review
- Evaluating performance and potential clinical benefit of the Swedish On Scene Injury Severity Prediction (OSISP) model for prehospital field triage on Norwegian trauma data.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Validation of the 2022 German trauma team activation criteria: a national registry study with focus on geriatric-specific modifiers.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Differences in emergency ambulance use between older and younger individuals in Denmark: a nationwide register-based study.Scientific reports · 2026Article
- ASA class is independently associated with 30-day mortality after mild traumatic brain injury with intracranial injury: a national retrospective cohort study.Acta neurochirurgica · 2026Article
- [The importance of the composition and activation of trauma teams].Chirurgie (Heidelberg, Germany) · 2026Article
- The Effect of Increasing Age on Outcomes in Major Trauma: A Retrospective Cohort Study.Emergency medicine Australasia : EMA · 2026Observational
- High Mortality and Medical Costs in Geriatric Trauma Patients: Surgical Treatment and Risk Factors from a Retrospective Cohort Study at a Level I Trauma Center.Annals of geriatric medicine and research · 2025Article
- Triage limitations in geriatric trauma: the need for tailored criteria.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Isolated Scalp Laceration in the Elderly: Association Between Age and Red Blood Cell Transfusion Despite Anatomically Minor Injury.Acute medicine & surgeryArticle
- Machine learning-based triage model for elderly traumatic brain injury patients in Chinese emergency department.Frontiers in neurologyArticle
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Authors and funding
28 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the aging population, the number of geriatric trauma patients continues to rise, posing significant challenges for emergency care and trauma management. Structured trauma team activation (TTA) protocols aim to provide timely and adequate treatment for severely injured patients. However, evidence suggests that current triage criteria may inadequately address the specific needs of geriatric patients, potentially leading to undertriage and worse outcomes.
methodsThe prospective, multicentre observational cohort study analysed trauma team activation and triage practices for patients aged ≥ 70 years across 12 Level 1 trauma centres across rural and urban regions in Germany and Switzerland. Data were prospectively collected from December 2020 to February 2021, following the STROBE guidelines. Triage decisions were compared with the TAcTIC (Trauma Team Activation and Trauma/Injury Care) consensus criteria to assess undertriage and overtriage rates. Key outcomes included trauma team activation rates, injury severity, transport characteristics, and early mortality.
resultsAmong 3,753 trauma patients, 1,371 (36.5%) were geriatric (≥ 70 years). Trauma team activation was significantly lower in the geriatric group (15.8%) compared to younger patients (31.8%), despite similar injury severity. Post-hoc analysis revealed that 53.8% of geriatric patients requiring trauma care were undertriaged. Head injuries (47.7%) and pelvic fractures (5.7%) were more common in geriatric patients in comparison to the younger cohort. Mortality within 48 h was more than three times as high in geriatric patients (1.8% vs. 0.5%).
conclusionA significant undertriage rate (53.8%) was identified among geriatric trauma patients, contributing to delayed care and increased mortality. Undertriage of geriatric trauma patients remains a critical issue, reflecting the insufficiency of current trauma activation protocols. Tailored triage criteria that even more consider age-related physiological differences, comorbidities, and frailty are urgently needed. Future updates to trauma guidelines should aim to reduce undertriage and improve outcomes for this vulnerable population. CLINICAL TRIAL NUMBER: Not applicable.
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