{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:09:09Z","timestamp":1790791749382,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Stavanger & Stavanger University Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>An increasing group of elderly patients is admitted after low energy falls. Several studies have shown that this patient group tends to be severely injured and is often undertriaged.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients\u2009&gt;\u200960\u00a0years with low energy fall (&lt;\u20091\u00a0m) as mechanism of injury were identified from the Stavanger University Hospital trauma registry. The study period was between 01.01.11 and 31.12.20. Patient and injury variables as well as clinical outcome were described. Undertriage was defined as patients with a major trauma, i.e., Injury Severity Score (ISS)\u2009&gt;\u200915, without trauma team activation. Statistical analysis was performed using the Chi-squared test for categorical variables and the Mann\u2013Whitney U test for continuous variables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over the 10-year study period, 388 patients\u2009&gt;\u200960\u00a0years with low energy fall as mechanism of injury were identified. Median age was 78\u00a0years (IQR 68\u201386), and 53% were males. The location of major injury was head injury in 41% of the patients, lower extremities in 19%, and thoracic injuries in 10%. Thirty-day mortality was 13%. Fifty percent were discharged to home, 31% to nursing home, 9% in hospital mortality, and the remaining 10% were transferred to other hospitals or rehabilitation facilities. Ninety patients had major trauma, and the undertriage was 48% (95% confidence interval, 38 to 58%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients aged\u2009&gt;\u200960\u00a0years with low energy falls are dominated by head injuries, and the 30-day mortality is 13%. Patients with major trauma are undertriaged in half the cases mandating increased awareness of this patient group.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-024-02465-3","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T07:06:00Z","timestamp":1707289560000},"page":"995-1001","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Characteristics and demography of low energy fall injuries in patients\u2009&gt;\u200960\u00a0years of age: a population-based analysis over a decade with focus on undertriage"],"prefix":"10.1007","volume":"50","author":[{"given":"Martine A.","family":"Aarsland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine H.","family":"Enoksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingvild","family":"Dalen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell Egil","family":"Tjosevik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Oord","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Thorsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"issue":"5","key":"2465_CR1","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/j.injury.2013.12.010","volume":"45","author":"JJ van Laarhoven","year":"2014","unstructured":"van Laarhoven JJ, Lansink KW, van Heijl M, Lichtveld RA, Leenen LP. Accuracy of the field triage protocol in selecting severely injured patients after high energy trauma. Injury. 2014;45(5):869\u201373.","journal-title":"Injury"},{"key":"2465_CR2","unstructured":"Sasser SM, Hunt RC, Faul M, Sugerman D, Pearson WS, Dulski T, et al. Guidelines for field triage of injured patients recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recomm Rep 2012;61(Rr-1):1\u201320"},{"key":"2465_CR3","unstructured":"Trauma ACoSCo. Resources for optimal care of the injured patient. 2014. pp 24\u201328."},{"issue":"1","key":"2465_CR4","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s13690-022-00891-6","volume":"80","author":"JA Haagsma","year":"2022","unstructured":"Haagsma JA, Charalampous P, Ariani F, Gallay A, Moesgaard Iburg K, Nena E, et al. The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study. Arch Public Health. 2022;80(1):142.","journal-title":"Arch Public Health"},{"issue":"10","key":"2465_CR5","doi-asserted-by":"publisher","first-page":"2527","DOI":"10.1007\/s00198-011-1888-3","volume":"23","author":"RO St\u00f8en","year":"2012","unstructured":"St\u00f8en RO, Nordsletten L, Meyer HE, Frihagen JF, Falch JA, Lofthus CM. Hip fracture incidence is decreasing in the high incidence area of Oslo. Norway Osteoporos Int. 2012;23(10):2527\u201334.","journal-title":"Norway Osteoporos Int"},{"key":"2465_CR6","doi-asserted-by":"publisher","unstructured":"Cuevas-\u00d8strem M, R\u00f8ise O, Wisborg T, Jeppesen E. Epidemiology of geriatric trauma patients in Norway: a nationwide analysis of Norwegian Trauma Registry data, 2015\u20132018. A retrospective cohort study. Injury. 2020;52(3):450\u20139. https:\/\/doi.org\/10.1016\/j.injury.2020.11.007.","DOI":"10.1016\/j.injury.2020.11.007"},{"issue":"11","key":"2465_CR7","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1016\/j.ajem.2015.07.044","volume":"33","author":"D Evans","year":"2015","unstructured":"Evans D, Pester J, Vera L, Jeanmonod D, Jeanmonod R. Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk. Am J Emerg Med. 2015;33(11):1635\u20138.","journal-title":"Am J Emerg Med"},{"key":"2465_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1757-7241-17-1","volume":"17","author":"M Rehn","year":"2009","unstructured":"Rehn M, Eken T, Kr\u00fcger AJ, Steen PA, Skaga NO, Lossius HM. Precision of field triage in patients brought to a trauma centre after introducing trauma team activation guidelines. Scand J Trauma Resusc Emerg Med. 2009;17:1.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"4","key":"2465_CR9","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/ans.12676","volume":"85","author":"H Lee","year":"2015","unstructured":"Lee H, Bein KJ, Ivers R, Dinh MM. Changing patterns of injury associated with low-energy falls in the elderly: a 10-year analysis at an Australian Major Trauma Centre. ANZ J Surg. 2015;85(4):230\u20134.","journal-title":"ANZ J Surg"},{"issue":"5","key":"2465_CR10","doi-asserted-by":"publisher","first-page":"3803","DOI":"10.1007\/s00068-021-01696-y","volume":"48","author":"K Thorsen","year":"2022","unstructured":"Thorsen K, Narvestad JK, Tjosevik KE, Larsen JW, Soreide K. Changing from a two-tiered to a one-tiered trauma team activation protocol: a before-after observational cohort study investigating the clinical impact of undertriage. Eur J Trauma Emerg Surg. 2022;48(5):3803\u201311. https:\/\/doi.org\/10.1007\/s00068-021-01696-y.","journal-title":"Eur J Trauma Emerg Surg."},{"issue":"1","key":"2465_CR11","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1752-2897-6-9","volume":"6","author":"HM Lossius","year":"2012","unstructured":"Lossius HM, Rehn M, Tjosevik KE, Eken T. Calculating trauma triage precision: effects of different definitions of major trauma. J Trauma Manag Outcomes. 2012;6(1):9.","journal-title":"J Trauma Manag Outcomes"},{"issue":"3","key":"2465_CR12","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/00005373-197403000-00001","volume":"14","author":"SP Baker","year":"1974","unstructured":"Baker SP, O\u2019Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187\u201396.","journal-title":"J Trauma"},{"key":"2465_CR13","unstructured":"Association for the Advancement of Automotive Medicine. 2016\u20132024. https:\/\/www.aaam.org\/abbreviated-injury-scale-ais\/about-ais\/."},{"issue":"Suppl 1","key":"2465_CR14","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","volume":"13","author":"S Cuschieri","year":"2019","unstructured":"Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31\u20134.","journal-title":"Saudi J Anaesth"},{"issue":"1","key":"2465_CR15","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.injury.2015.07.003","volume":"47","author":"CS Palmer","year":"2016","unstructured":"Palmer CS, Gabbe BJ, Cameron PA. Defining major trauma using the 2008 Abbreviated Injury Scale. Injury. 2016;47(1):109\u201315.","journal-title":"Injury"},{"issue":"5","key":"2465_CR16","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1097\/TA.0000000000001814","volume":"84","author":"JW Roden-Foreman","year":"2018","unstructured":"Roden-Foreman JW, Rapier NR, Yelverton L, Foreman ML. Avoiding Cribari gridlock: the standardized triage assessment tool improves the accuracy of the Cribari matrix method in identifying potential overtriage and undertriage. J Trauma Acute Care Surg. 2018;84(5):718\u201326.","journal-title":"J Trauma Acute Care Surg"},{"key":"2465_CR17","first-page":"1","volume":"43","author":"OA Samin","year":"1999","unstructured":"Samin OA. The new injury severity score versus the injury severity score in predicting patient outcome: a comparative evaluation on trauma service patients of the Auckland Hospital. Ann Adv Automot Med. 1999;43:1\u201315.","journal-title":"Ann Adv Automot Med"},{"key":"2465_CR18","unstructured":"Sullivan KM. Open Epi: version 3.01. 2013.\u00a0https:\/\/www.openepi.com\/Proportion\/Proportion.htm."},{"issue":"4","key":"2465_CR19","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.jamda.2016.12.086","volume":"18","author":"M Cesari","year":"2017","unstructured":"Cesari M, P\u00e9rez-Zepeda MU, Marzetti E. Frailty and multimorbidity: different ways of thinking about geriatrics. J Am Med Dir Assoc. 2017;18(4):361\u20134.","journal-title":"J Am Med Dir Assoc"},{"issue":"6","key":"2465_CR20","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.jamda.2013.03.022","volume":"14","author":"JE Morley","year":"2013","unstructured":"Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392\u20137.","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"2465_CR21","doi-asserted-by":"publisher","first-page":"e010989","DOI":"10.1136\/bmjopen-2015-010989","volume":"6","author":"SS Mortazavi","year":"2016","unstructured":"Mortazavi SS, Shati M, Keshtkar A, Malakouti SK, Bazargan M, Assari S. Defining polypharmacy in the elderly: a systematic review protocol. BMJ Open. 2016;6(3):e010989.","journal-title":"BMJ Open"},{"issue":"5\u20136","key":"2465_CR22","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s10354-021-00903-0","volume":"172","author":"P Dovjak","year":"2022","unstructured":"Dovjak P. Polypharmacy in elderly people. Wien Med Wochenschr. 2022;172(5\u20136):109\u201313.","journal-title":"Wien Med Wochenschr"},{"issue":"4","key":"2465_CR23","first-page":"275","volume":"105","author":"CA Pfortmueller","year":"2014","unstructured":"Pfortmueller CA, Lindner G, Exadaktylos AK. Reducing fall risk in the elderly: risk factors and fall prevention, a systematic review. Minerva Med. 2014;105(4):275\u201381.","journal-title":"Minerva Med"},{"issue":"1","key":"2465_CR24","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.maturitas.2013.02.009","volume":"75","author":"AF Ambrose","year":"2013","unstructured":"Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51\u201361.","journal-title":"Maturitas"},{"issue":"6","key":"2465_CR25","first-page":"520","volume":"21","author":"SD Adams","year":"2015","unstructured":"Adams SD, Holcomb JB. Geriatric trauma. Curr Opin Crit Care. 2015;21(6):520\u20136.","journal-title":"Curr Opin Crit Care"},{"issue":"6","key":"2465_CR26","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1111\/aas.12330","volume":"58","author":"HK Bakke","year":"2014","unstructured":"Bakke HK, Dehli T, Wisborg T. Fatal injury caused by low-energy trauma - a 10-year rural cohort. Acta Anaesthesiol Scand. 2014;58(6):726\u201332.","journal-title":"Acta Anaesthesiol Scand"},{"issue":"4","key":"2465_CR27","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1007\/s00068-022-02186-5","volume":"49","author":"A Benhamed","year":"2023","unstructured":"Benhamed A, Fraticelli L, Claustre C, Gossiome A, Cesareo E, Heidet M, et al. Risk factors and mortality associated with undertriage after major trauma in a physician-led prehospital system: a retrospective multicentre cohort study. Eur J Trauma Emerg Surg. 2023;49(4):1707\u201315. https:\/\/doi.org\/10.1007\/s00068-022-02186-5.","journal-title":"Eur J Trauma Emerg Surg."},{"key":"2465_CR28","unstructured":"traumatologi NKf. Traumeplan NKT. 2020.\u00a0https:\/\/traumeplan.no\/index.php?action=showtopic&topic=mxkjMqkD."},{"issue":"2","key":"2465_CR29","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1097\/TA.0b013e31825c7cf4","volume":"73","author":"E Bradburn","year":"2012","unstructured":"Bradburn E, Rogers FB, Krasne M, Rogers A, Horst MA, Beelen MJ, et al. High-risk geriatric protocol: improving mortality in the elderly. J Trauma Acute Care Surg. 2012;73(2):435\u201340.","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"2465_CR30","first-page":"813","volume":"69","author":"DS Heffernan","year":"2010","unstructured":"Heffernan DS, Thakkar RK, Monaghan SF, Ravindran R, Adams CA Jr, Kozloff MS, et al. Normal presenting vital signs are unreliable in geriatric blunt trauma victims. J Trauma. 2010;69(4):813\u201320.","journal-title":"J Trauma"},{"issue":"2","key":"2465_CR31","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1097\/TA.0000000000000523","volume":"78","author":"JB Brown","year":"2015","unstructured":"Brown JB, Gestring ML, Forsythe RM, Stassen NA, Billiar TR, Peitzman AB, et al. Systolic blood pressure criteria in the National Trauma Triage Protocol for geriatric trauma: 110 is the new 90. J Trauma Acute Care Surg. 2015;78(2):352\u20139.","journal-title":"J Trauma Acute Care Surg"},{"issue":"10","key":"2465_CR32","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1046\/j.1365-2168.2002.02210.x","volume":"89","author":"D Demetriades","year":"2002","unstructured":"Demetriades D, Karaiskakis M, Velmahos G, Alo K, Newton E, Murray J, et al. Effect on outcome of early intensive management of geriatric trauma patients. Br J Surg. 2002;89(10):1319\u201322.","journal-title":"Br J Surg"},{"issue":"11","key":"2465_CR33","doi-asserted-by":"publisher","first-page":"e2025889","DOI":"10.1001\/jamanetworkopen.2020.25889","volume":"3","author":"PC Dykes","year":"2020","unstructured":"Dykes PC, Burns Z, Adelman J, Benneyan J, Bogaisky M, Carter E, et al. Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA Netw Open. 2020;3(11):e2025889.","journal-title":"JAMA Netw Open"},{"issue":"27","key":"2465_CR34","doi-asserted-by":"publisher","first-page":"875","DOI":"10.15585\/mmwr.mm6927a5","volume":"69","author":"B Moreland","year":"2020","unstructured":"Moreland B, Kakara R, Henry A. Trends in nonfatal falls and fall-related injuries among adults aged \u226565 years - United States, 2012\u20132018. MMWR Morb Mortal Wkly Rep. 2020;69(27):875\u201381.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"2465_CR35","first-page":"220","volume":"96","author":"R Lee","year":"2017","unstructured":"Lee R. The CDC\u2019s STEADI initiative: promoting older adult health and independence through fall prevention. Am Fam Physician. 2017;96(4):220\u20131.","journal-title":"Am Fam Physician"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02465-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-024-02465-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02465-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T09:08:24Z","timestamp":1721034504000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-024-02465-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,7]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["2465"],"URL":"https:\/\/doi.org\/10.1007\/s00068-024-02465-3","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,7]]},"assertion":[{"value":"7 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}