{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:27:22Z","timestamp":1786944442974,"version":"build-2736575974"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bell Family Legacy Fund"},{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","award":["2022RES00001"],"award-info":[{"award-number":["2022RES00001"]}],"id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Western Australian Centre for Health and Ageing"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults account for a rising proportion of trauma admissions, yet most prognostic tools for this group predict mortality alone. A validated multi-outcome model could support early risk stratification and optimize trauma care planning. This study developed and validated the Older Trauma Outcome Prediction (OTOP) model, the first tool designed to estimate multiple inpatient outcomes in older trauma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used Western Australia Trauma Registry linked data on patients aged \u2265 50 years admitted after external injury (2000\u20132020). Predictor variables, identified from a systematic review, included demographic factors, co-morbidities, injury characteristics, physiological measurements, and resuscitation indicators. The cohort was randomly divided into training (80%) and validation (20%) sets. Ridge logistic regression was used for binary outcomes (in-hospital mortality, surgery, intensive care unit (ICU) admission, medical complications), multinomial logistic regression was used for discharge destination, and quasi-Poisson regression was used for hospital length of stay. Model performance was assessed using the area under the curve (AUC), calibration, and error metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study analysed 105 972 trauma admissions aged \u2265 50 years between 2000 and 2020 (84 778 patients in the training cohort, 21 194 in the validation cohort). The mean age of all patients was 74.0 years, and 45.3% were men. Mortality prediction showed excellent discrimination (AUC 0.95), outperforming the Geriatric Trauma Outcome Score (AUC 0.83). The surgery and ICU admission models performed well (AUC 0.97 and 0.96, respectively). Length-of-hospital-stay prediction demonstrated moderate accuracy (mean absolute error 4.9 days), whereas prediction of medical complications was limited (AUC 0.60). Discharge destination was accurately classified into home, rehabilitation, residential care, or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OTOP is the first validated multi-outcome prognostic model for older trauma patients, providing accurate and clinically relevant predictions to support early decision-making and optimize trauma system resource use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag084","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T11:44:18Z","timestamp":1779536658000},"source":"Crossref","is-referenced-by-count":0,"title":["Multi-outcome prognostic modelling for older adults after trauma: development and validation of the Older Trauma Outcome Predictor (OTOP) model"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0631-5797","authenticated-orcid":false,"given":"Mayura","family":"Iddagoda","sequence":"first","affiliation":[{"name":"School of Medicine, University of Western Australia , Perth, Western Australia ,","place":["Australia"]},{"name":"Perioperative and Aged Care Service, Royal Perth Hospital , Perth, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Trevenen","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Western Australia , Perth, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter G","family":"Weber","sequence":"additional","affiliation":[{"name":"State Adult Major Trauma Service, Royal Perth Hospital , Perth, Western Australia ,","place":["Australia"]},{"name":"School of Surgery, University of Western Australia , Perth, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Etherton-Beer","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Western Australia , Perth, Western Australia ,","place":["Australia"]},{"name":"Perioperative and Aged Care Service, Royal Perth Hospital , Perth, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3650-0475","authenticated-orcid":false,"given":"Leon","family":"Flicker","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Western Australia , Perth, Western Australia ,","place":["Australia"]},{"name":"Perioperative and Aged Care Service, Royal Perth Hospital , Perth, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"2026081701215842200_zrag084-B1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.5811\/westjem.2017.5.33615","article-title":"Trends and characteristics of emergency department visits for fall-related injuries in older adults, 2003\u20132010","volume":"18","author":"Shankar","year":"2017","journal-title":"West J Emerg Med"},{"key":"2026081701215842200_zrag084-B2","doi-asserted-by":"crossref","first-page":"e2690","DOI":"10.1590\/1518-8345.0959.2690","article-title":"Trauma in elderly people: access to the health system through pre-hospital care","volume":"24","author":"Silva","year":"2016","journal-title":"Rev Lat Am Enfermagem"},{"key":"2026081701215842200_zrag084-B3","doi-asserted-by":"crossref","first-page":"146","DOI":"10.4103\/JETS.JETS_62_16","article-title":"Older age, illnesses, and injury severity affect immediate outcome in elderly trauma patients","volume":"10","author":"Kirshenbom","year":"2017","journal-title":"J Emerg Trauma Shock"},{"key":"2026081701215842200_zrag084-B4","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1001\/archsurg.138.10.1093","article-title":"Trauma in the elderly patient","volume":"138","author":"Victorino","year":"2003","journal-title":"Arch Surg"},{"key":"2026081701215842200_zrag084-B5","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/00005373-198704000-00005","article-title":"Evaluating trauma care: the TRISS method","volume":"27","author":"Boyd","year":"1987","journal-title":"J Trauma Acute Care Surg"},{"key":"2026081701215842200_zrag084-B6","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1089\/jpm.2015.0027","article-title":"Estimating geriatric mortality after injury using age, injury severity, and performance of a transfusion: the Geriatric Trauma Outcome Score","volume":"18","author":"Zhao","year":"2015","journal-title":"J Palliat Med"},{"key":"2026081701215842200_zrag084-B7","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/TA.0000000000002569","article-title":"Predictors of elderly mortality after trauma: a novel outcome score","volume":"88","author":"Morris","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2026081701215842200_zrag084-B8","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.3390\/jcm10071362","article-title":"The GERtality score: the development of a simple tool to help predict in-hospital mortality in geriatric trauma patients","volume":"10","author":"Scherer","year":"2021","journal-title":"J Clin Med"},{"key":"2026081701215842200_zrag084-B9","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/TA.0000000000000926","article-title":"Multicenter external validation of the Geriatric Trauma Outcome Score: a study by the Prognostic Assessment of Life and Limitations After Trauma in the Elderly (PALLIATE) consortium","volume":"80","author":"Cook","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2026081701215842200_zrag084-B10","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1177\/000313481808400835","article-title":"Postdischarge mortality after geriatric low-level falls: a five-year analysis","volume":"84","author":"Gerrish","year":"2018","journal-title":"Am Surg"},{"key":"2026081701215842200_zrag084-B11","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/TA.0000000000004320","article-title":"Identifying factors predicting outcomes after major trauma in older patients: prognostic systematic review and meta-analysis","volume":"97","author":"Iddagoda","year":"2024","journal-title":"J Trauma Acute Care Surg"},{"key":"2026081701215842200_zrag084-B12","doi-asserted-by":"crossref","first-page":"71","DOI":"10.20408\/jti.2021.0060","article-title":"Evolution of trauma care and the trauma registry in the West Australian 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