90 1.181-3.057 <0.01 Low GCS in ED 0.883 0.845-0.924 <0.0001 Creatinine in ED 1.003 1.000-1.005 0.03 Discharge to ALF 0.315 0.214-0.463 <0.0001 GCS–Glasgow coma scale; ED–emergency department; ALF–assisted living Citarinostat datasheet facility. Discussion The major finding of this study is that in the Emricasan in vivo elderly population following severe trauma, long term survival can be predicted based on the pre-hospital parameters of age, mechanism of injury, and GCS on admission. In contrast, parameters in hospital care, including blood transfusion, requirement for ICU admission,

surgical procedures and complications did not predict long term survival in this elderly group. There is a paucity of data describing the long term outcome of the injured geriatric patient, accordingly, this was a primary objective of our study. Contrary to what is often assumed, we have demonstrated that long term survival subsequent to a severe trauma in the elderly population is not uncommon, for we noted that almost two-thirds of elderly patients who were discharged from the hospital were alive at a mean follow up of over 4 years. Previous reports have analyzed the course and in-hospital outcome of elderly patients following Selleckchem LY2090314 trauma [4, 11, 12]. A mature trauma system performance could be assessed by the percent of severely injured patients who are discharged

from the trauma center. For example, Florida trauma system analysis over a 15 year period showed significant increase in both the number of elderly injured and the severity of injury [13]. Others [14] stressed the importance of triage of the severely injured elderly patients to designated trauma centers. This resulted in significantly higher overall discharge when compared to non-trauma centers. Not surprisingly, and in concert with others [4, 15] our Dolichyl-phosphate-mannose-protein mannosyltransferase data demonstrated that chronological

age is a predictor of post-discharge mortality. The post-discharge survival of patients ≥ 80 years is significantly worse compared to their younger counterparts. These intuitive findings could not be explained by the ISS, which was not different between the age groups. Although age related co-morbidities likely contribute to long term survival, we were surprised to note that age, rather than co-morbidities and ISS, was an independent predictor of death, particularly in the ≥80 age group. It has been noted that in the elderly population, multi-system trauma from falls predominant with increasing age, with a corresponding decreasing frequency of motor vehicular and pedestrian related injuries [5]. Similarly, we noted that falls were the most common mechanism of injury and were associated with poor long term outcome. It has been suggested that a senior’s propensity to fall may indicate poor functional capacity and higher mortality risk in this population [16]. Various studies confirm that pre-existing co-morbidities significantly increase the risk of mortality following blunt trauma in geriatric patients [17–20].