Injury Patterns in Elderly Drivers

Graciela Bauza, Wayne LaMorte, Peter A Burke, Erwin F Hirsch
Boston Medical Center, Boston, MA

Objective: The higher mortality among motor vehicle collision (MVC) elderly drivers (70+) is of rising concern because of the aging of the population. The purpose of this study was to determine whether the elderly have specific patterns of injury that may be responsible for the increase in mortality.
Design: Retrospective cohort study.
Setting: Level I Urban Trauma Center.
Patients: The sample consisted of 1040 consecutive drivers admitted to Boston Medical Center after a MVC from 10/2001 to 10/2004. Patients were categorized into five age groups (<26, 26-39, 40-54, 55-69, 70+yo). Approximately 8% of the sample was 70 years old or older.
Interventions: None.
Main Outcome Measures: Injury Severity Score (ISS), Abbreviated Injury Score (AIS), Length of stay (LOS), Mortality, Discharge disposition.
Results: Differences amongst age groups were tested for significance with ANOVA. Use of safety devices did not differ among age groups (p=0.84). Nevertheless, elderly drivers had the highest ISS (14.6 ± 1.3; p=0.0002) compared to all other age groups. This difference was driven by a significantly higher head and neck abbreviated injury score (2.8 ± 0.2; p=0.005). There were no significant differences among age groups with respect to face, chest, abdomen/pelvis, or extremities AIS. Elderly drivers also had the highest mortality rates (17%; p=0.001), greatest hospital LOS (11.1 ± 1.3; p=0.0001), and the lowest likelihood of discharge to home (31%).
Conclusions: Increased mortality in elderly drivers is due to higher ISS and more specifically AIS for head and neck injuries.

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