{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:00:16Z","timestamp":1792479616374,"version":"4.5.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["33239"],"award-info":[{"award-number":["33239"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fondation du CHU de Qu\u00e9bec-Universit\u00e9 Laval"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults have become a significant portion of the trauma population. Exploring their specificities is crucial to better meet their specific needs. The primary objective was to evaluate the temporal changes in the incidence, demographic and trauma characteristics, injury pattern, in-hospital admission, complications, and outcome of older trauma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study was conducted using the Quebec Trauma Registry. Patients aged \u226516 years admitted to one of the three adult level-I trauma centers between 2003 and 2017 were included. Descriptive analyses and trend-tests were performed to describe temporal changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 53,324 patients were included, and 24,822 were aged \u226565 years. The median [IQR] age increased from 57[36\u201377] to 67[46\u201382] years, and the proportion of older adults rose from 41.8% in 2003 to 54.1% in 2017. Among those, falls remain the main mechanism (84.7%-88.3%), and the proportion of severe thorax (+8.9%), head (+8.7%), and spine (+5%) injuries significantly increased over time. The proportion of severely injured older patients almost doubled (17.6%-32.3%), yet their mortality decreased (-1.0%). Their average annual bed-days consumption also increased (+15,004 and +1,437 in non-intensive care wards and ICU, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Since 2014, older adults have represented the majority of admissions in Level-I trauma centers in Qu\u00e9bec. Their bed-days consumption has greatly increased, and their injury pattern and severity have deeply evolved, while we showed a decrease in mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0280345","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T14:44:28Z","timestamp":1675089868000},"page":"e0280345","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":41,"title":["Epidemiology, injury pattern and outcome of older trauma patients: A 15-year study of level-I trauma centers"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8784-5273","authenticated-orcid":true,"given":"Axel","family":"Benhamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Batomen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Boucher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishan","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9ric","family":"Mercier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chartelin Jean","family":"Isaac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lanie","family":"B\u00e9rub\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Bernard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean- Marc","family":"Chauny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-6960","authenticated-orcid":true,"given":"Marie Jos\u00e9e","family":"Sirois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-1258","authenticated-orcid":true,"given":"Karim","family":"Tazarourte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaury","family":"Gossiome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-8110","authenticated-orcid":true,"given":"Marcel","family":"\u00c9mond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"issue":"10258","key":"pone.0280345.ref001","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"T Vos","year":"2020","journal-title":"The Lancet"},{"issue":"1\u20132","key":"pone.0280345.ref002","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1445-2197.2012.06180.x","article-title":"Growing trend in older patients with severe injuries: mortality and mechanisms of injury between 1991 and 2010 at an inner city major trauma centre.","volume":"83","author":"MM Dinh","year":"2013","journal-title":"ANZ J Surg"},{"issue":"12","key":"pone.0280345.ref003","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1136\/emermed-2015-205265","article-title":"The changing face of major trauma in the UK.","volume":"32","author":"A Kehoe","year":"2015","journal-title":"Emerg Med J"},{"issue":"1","key":"pone.0280345.ref004","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s13017-020-00340-1","article-title":"The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients","volume":"15","author":"L Jiang","year":"2020","journal-title":"World Journal of Emergency Surgery"},{"key":"pone.0280345.ref005","unstructured":"Statistics Canada CoP, Statistics Canada Catalogue no. 98-400-X2016001. Available from: https:\/\/www12.statcan.gc.ca\/census-recensement\/2016\/dp-pd\/dt-td\/Rp-eng.cfm?LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GID=0&GK=0&GRP=1&PID=109523&PRID=10&PTYPE=109445&S=0&SHOWALL=0&SUB=0&Temporal=2016&THEME=115&VID=0&VNAMEE=&VNAMEF=."},{"issue":"6","key":"pone.0280345.ref006","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1177\/000313481207800628","article-title":"Old and undertriaged: a lethal combination.","volume":"78","author":"A Rogers","year":"2012","journal-title":"Am Surg."},{"issue":"8","key":"pone.0280345.ref007","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1001\/archsurg.143.8.776","article-title":"Undertriage of elderly trauma patients to state-designated trauma centers.","volume":"143","author":"DC Chang","year":"2008","journal-title":"Arch Surg."},{"issue":"2","key":"pone.0280345.ref008","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.annemergmed.2019.06.018","article-title":"National Study of Triage and Access to Trauma Centers for Older Adults","volume":"75","author":"T Uribe-Leitz","year":"2020","journal-title":"Annals of Emergency Medicine"},{"issue":"3","key":"pone.0280345.ref009","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/00005373-200209000-00001","article-title":"Trauma in the elderly: intensive care unit resource use and outcome.","volume":"53","author":"MD Taylor","year":"2002","journal-title":"The Journal of Trauma: Injury, Infection, and Critical Care."},{"issue":"6","key":"pone.0280345.ref010","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.injury.2016.02.027","article-title":"Factors affecting mortality in older trauma patients-A systematic review and meta-analysis.","volume":"47","author":"I Sammy","year":"2016","journal-title":"Injury"},{"issue":"4","key":"pone.0280345.ref011","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.injury.2008.10.016","article-title":"Severe and multiple trauma in older patients; incidence and mortality.","volume":"40","author":"PV Giannoudis","year":"2009","journal-title":"Injury"},{"key":"pone.0280345.ref012","volume-title":"In: Continuum de services en traumatologie","author":"Institut national d\u2019excellence en sant\u00e9 et services sociaux","year":"2015"},{"key":"pone.0280345.ref013","volume-title":"Resources for optimal care of the injured patient.","author":"American College of Surgeons, Committee on Trauma","year":"2014"},{"key":"pone.0280345.ref014","article-title":"Accreditation in health care: does it make any difference to patient outcomes?","author":"N Bracewell","year":"2021","journal-title":"BMJ Qual Saf"},{"issue":"2","key":"pone.0280345.ref015","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/0974-2700.110754","article-title":"Evaluating trauma center process performance in an integrated trauma system with registry data","volume":"6","author":"L Moore","year":"2013","journal-title":"J Emerg Trauma Shock"},{"issue":"9596","key":"pone.0280345.ref016","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"370","author":"E von Elm","year":"2007","journal-title":"The Lancet"},{"key":"pone.0280345.ref017","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1757-7241-19-29","article-title":"Development and validation of a complementary map to enhance the existing 1998 to 2008 Abbreviated Injury Scale map","volume":"19","author":"CS Palmer","year":"2011","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"1","key":"pone.0280345.ref018","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.injury.2015.07.003","article-title":"Defining major trauma using the 2008 Abbreviated Injury Scale.","volume":"47","author":"CS Palmer","year":"2016","journal-title":"Injury"},{"issue":"2","key":"pone.0280345.ref019","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/TA.0000000000000366","article-title":"Complications to evaluate adult trauma care: An expert consensus study","volume":"77","author":"L Moore","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"pone.0280345.ref020","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s41999-020-00426-8","article-title":"A European Research Agenda for Geriatric Emergency Medicine: a modified Delphi study.","volume":"12","author":"SP Mooijaart","year":"2021","journal-title":"Eur Geriatr Med"},{"issue":"1","key":"pone.0280345.ref021","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s13017-020-00340-1","article-title":"The incidence of geriatric trauma is increasing and comparison of different scoring tools for the prediction of in-hospital mortality in geriatric trauma patients.","volume":"15","author":"L Jiang","year":"2020","journal-title":"World J Emerg Surg"},{"issue":"7","key":"pone.0280345.ref022","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.injury.2016.04.002","article-title":"Traumatic injury in the United States: In-patient epidemiology 2000\u20132011.","volume":"47","author":"C DiMaggio","year":"2016","journal-title":"Injury"},{"issue":"6","key":"pone.0280345.ref023","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1136\/injuryprev-2014-041199","article-title":"Incidence trends of injury among the elderly in Spain, 2000\u20132010.","volume":"20","author":"E Cirera","year":"2014","journal-title":"Inj Prev"},{"issue":"3","key":"pone.0280345.ref024","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.annemergmed.2018.09.034","article-title":"Age-Related Characteristics and Outcomes for Patients With Severe Trauma: Analysis of Japan\u2019s Nationwide Trauma Registry","volume":"73","author":"M Kojima","year":"2019","journal-title":"Annals of Emergency Medicine"},{"issue":"11","key":"pone.0280345.ref025","doi-asserted-by":"crossref","first-page":"354","DOI":"10.47102\/annals-acadmedsg.V48N11p354","article-title":"The Changing Epidemiology of Serious Trauma in the Elderly Population: An Increasing Concern of a Tertiary Hospital in Singapore.","volume":"48","author":"KT Go","year":"2019","journal-title":"Ann Acad Med Singap."},{"issue":"2","key":"pone.0280345.ref026","doi-asserted-by":"crossref","first-page":"e018635","DOI":"10.1136\/bmjopen-2017-018635","article-title":"Ten-year inhospital mortality trends for patients with trauma in Japan: a multicentre observational study","volume":"8","author":"I Nagata","year":"2018","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0280345.ref027","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s00268-018-4794-4","article-title":"Trauma in the Elderly: Demographic Trends (1995\u20132014) in a Major New Zealand Trauma Centre.","volume":"43","author":"M Burstow","year":"2019","journal-title":"World J Surg."},{"key":"pone.0280345.ref028","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.jss.2021.02.047","article-title":"Trends in Geriatric Ground-Level Falls: Report from the National Trauma Data Bank","volume":"266","author":"M Khurrum","year":"2021","journal-title":"Journal of Surgical Research"},{"key":"pone.0280345.ref029","article-title":"A retrospective cohort study of 27,049 polytraumatized patients age 60 and above: identifying changes over 16 years.","author":"Y Kalbas","year":"2021","journal-title":"Eur Geriatr Med."},{"issue":"6","key":"pone.0280345.ref030","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1136\/emermed-2018-207943","article-title":"Ageing population has changed the nature of major thoracic injury","volume":"36","author":"N Ferrah","year":"2019","journal-title":"Emerg Med J"},{"issue":"5","key":"pone.0280345.ref031","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1097\/01.TA.0000162138.36519.2A","article-title":"Computed tomography versus plain radiography to screen for cervical spine injury: a meta-analysis.","volume":"58","author":"JF Holmes","year":"2005","journal-title":"The Journal of Trauma: Injury, Infection, and Critical Care."},{"issue":"2","key":"pone.0280345.ref032","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jemermed.2018.10.032","article-title":"Blunt Thoracolumbar-Spine Trauma Evaluation in the Emergency Department: A Meta-Analysis of Diagnostic Accuracy for History, Physical Examination, and Imaging.","volume":"56","author":"J VandenBerg","year":"2019","journal-title":"J Emerg Med."},{"issue":"2","key":"pone.0280345.ref033","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/01.ta.0000226154.38852.e6","article-title":"Spiral computed tomography for the initial evaluation of spine trauma: A new standard of care?","volume":"61","author":"JL Antevil","year":"2006","journal-title":"The Journal of Trauma: Injury, Infection, and Critical Care."},{"issue":"9","key":"pone.0280345.ref034","doi-asserted-by":"crossref","first-page":"e580","DOI":"10.1016\/S2666-7568(21)00172-0","article-title":"Global, regional, and national burden of bone fractures in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019","volume":"2","year":"2021","journal-title":"Lancet Healthy Longev."},{"issue":"9","key":"pone.0280345.ref035","first-page":"1225","article-title":"Incidence of Hip Fracture Over 4","volume":"180","author":"J Swayambunathan","year":"2020","journal-title":"Decades in the Framingham Heart Study. JAMA Intern Med"},{"issue":"5","key":"pone.0280345.ref036","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s00068-017-0870-y","article-title":"Changes in trauma management following the implementation of the whole-body computed tomography: a retrospective multi-centre study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(\u00ae)).","volume":"44","author":"HG Palm","year":"2018","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"2","key":"pone.0280345.ref037","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1093\/ageing\/afz151","article-title":"Age and the distribution of major injury across a national trauma system.","volume":"49","author":"JR Dixon","year":"2020","journal-title":"Age Ageing."},{"issue":"4","key":"pone.0280345.ref038","doi-asserted-by":"crossref","first-page":"R143","DOI":"10.1186\/cc13976","article-title":"Factors influencing lengths of stay in the intensive care unit for surviving trauma patients: a retrospective analysis of 30,157 cases.","volume":"18","author":"AB B\u00f6hmer","year":"2014","journal-title":"Crit Care."},{"issue":"1","key":"pone.0280345.ref039","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1177\/0885066611432420","article-title":"The cumulative effect of multiple critical care protocols on length of stay in a geriatric trauma population.","volume":"28","author":"TA Frederickson","year":"2013","journal-title":"J Intensive Care Med"},{"issue":"10","key":"pone.0280345.ref040","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1001\/jamasurg.2013.2148","article-title":"Excessively long hospital stays after trauma are not related to the severity of illness: let\u2019s aim to the right target!","volume":"148","author":"JO Hwabejire","year":"2013","journal-title":"JAMA Surg"},{"issue":"6","key":"pone.0280345.ref041","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jamcollsurg.2010.01.028","article-title":"Frailty as a predictor of surgical outcomes in older patients.","volume":"210","author":"MA Makary","year":"2010","journal-title":"J Am Coll Surg"},{"issue":"5","key":"pone.0280345.ref042","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/JTN.0000000000000233","article-title":"Risk Factors for Complications of Traumatic Injuries","volume":"23","author":"W de Aguiar J\u00fanior","year":"2016","journal-title":"J Trauma Nurs"},{"issue":"9","key":"pone.0280345.ref043","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/j.injury.2012.05.019","article-title":"The risk factors for the development of complications during the recovery phase following blunt chest wall trauma: a retrospective study","volume":"44","author":"CE Battle","year":"2013","journal-title":"Injury"},{"issue":"1","key":"pone.0280345.ref044","doi-asserted-by":"crossref","first-page":"13803","DOI":"10.1038\/s41598-021-93314-5","article-title":"The impact of infection complications after trauma differs according to trauma severity.","volume":"11","author":"A Komori","year":"2021","journal-title":"Sci Rep."},{"issue":"3","key":"pone.0280345.ref045","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/BOT.0000000000001052","article-title":"Ten-Year Incidence of High-Energy Geriatric Trauma at a Level 1 Trauma Center.","volume":"32","author":"JA Lowe","year":"2018","journal-title":"J Orthop Trauma."},{"issue":"3","key":"pone.0280345.ref046","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.annemergmed.2018.09.034","article-title":"Age-Related Characteristics and Outcomes for Patients With Severe Trauma: Analysis of Japan\u2019s Nationwide Trauma Registry","volume":"73","author":"M Kojima","year":"2019","journal-title":"Annals of Emergency Medicine"},{"key":"pone.0280345.ref047","article-title":"Injury profiles and clinical management of older patients with major trauma.","author":"N Ferrah","year":"2021","journal-title":"Australas J Ageing."},{"issue":"1","key":"pone.0280345.ref048","doi-asserted-by":"crossref","first-page":"19148","DOI":"10.1038\/s41598-020-76149-4","article-title":"Characteristics, injuries, and clinical outcomes of geriatric trauma patients in Japan: an analysis of the nationwide trauma registry database.","volume":"10","author":"Y Miyoshi","year":"2020","journal-title":"Sci Rep."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0280345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T14:45:15Z","timestamp":1675089915000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0280345"}},"subtitle":[],"editor":[{"given":"Yusuke","family":"Tsutsumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,30]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0280345","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,30]]}}}