Objectives: To determine whether the Vulnerable Elders Survey (VES)-13, a survey based on functional status that has been validated in uninjured older populations, will predict complications and mortality in injured older adults.
Design: Prospective observational pilot study.
Setting: Level 1 trauma center.
Participants: Sixty-three older adults (≥65) with a traumatic injury who survived and required inpatient care for at least 24 hours.
Predictor: preinjury VES-13 score (0-10 points, higher=greater risk) obtained by interviewing participants or proxies.
Outcomes: composite outcome of one or more medical complications (e.g., aspiration pneumonia, respiratory failure) or death, discharge destination (home, nursing home, death), length of stay, hospital charges. Covariates: Charlson Comorbidity Index (CCI), Injury Severity Score (ISS), and sex.
Results: Of the 63 participants, 30 (48%) were discharged to home and 28 (44%) to a nursing facility, 21 (33%) developed one or more complications, and four (6%) died. In a model that also controlled for ISS and comorbidity, each additional VES-13 point was associated with greater risk of complication or death (odds ratio=1.53 per point, 95% confidence interval=1.12-2.07).
Conclusion: The VES-13, in combination with injury severity, may be useful early in the hospital course to predict complications and death in older adults with traumatic injury, potentially identifying candidates who may benefit from additional inpatient geriatric services.
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.