Analysis of injury patterns in older adults: a cohort study

BACKGROUND: The increasing proportion of the older adult population is associated with a rising incidence of injuries, predominantly osteoporotic fractures, which places a substantial burden on healthcare systems. Despite the high prevalence of this problem, data on injury patterns, seasonal variability, and clinical and organizational aspects of care for this patient population in the setting of emergency hospitalization remain limited. AIM: To assess the distribution and clinical characteristics of traumatic injuries in older patients admitted on an emergency basis; to identify factors influencing the course and outcomes of traumatic disease; and to analyze treatment strategies depending on the severity of comorbid conditions. METHODS: A retrospective, single-center, cohort study was conducted. The analysis included 3588 patients aged ≥ 56 years who were admitted to the trauma department of a multidisciplinary hospital (Moscow) between 2021 and 2024 for an emergency. RESULTS: Women accounted for 67.9% of the cohort (n = 2438). The mean patient age was 72.74 ± 10.0 years. The highest number of hospital admissions occurred during the winter season (32.3%). Low-energy fractures predominated, most commonly fractures of the proximal femur (33.18%) and the humerus (17.06%). Comorbid conditions were identified in 85.9% of patients, most frequently hypertension (35.5%) and chronic heart failure (19.2%). The mean length of hospital stay was 10.7 ± 9.2 days and increased with older age and in cases of polytrauma. The primary outcome, in-hospital mortality, was 5.3% (95% confidence interval, 4.6–6.1); a total of 190 patients died (135 women and 55 men). CONCLUSION: The findings confirm a high prevalence of severe osteoporotic injuries among older patients requiring emergency hospitalization. Timely surgical intervention and a multidisciplinary approach were associated with improved clinical outcomes.