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Gender Differences in Transportation to Trauma Center amongst Older Adults with Head Injuries
EP23841
Poster Title: Gender Differences in Transportation to Trauma Center amongst Older Adults with Head Injuries
Submitted on 26 Feb 2016
Author(s): Anto-Ocrah M, Jones CMC, Bazarian J, Cushman JT,  Dozier A, Gillespie S, Caterino J, Cheng J, Shah MN
Affiliations: DIVISION OF EPIDEMIOLOGY, DIVISION OF EMERGENCY MEDICINE RESEARCH. UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
This poster was presented at The PINKconcussions International Summit on Female Concussion and TBI
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Poster Information
Abstract: Background
Older adults are more likely to be transported to a non-trauma center by prehospital emergency medical services (EMS) compared to younger adults with similar injuries. Little is known about the gender differences in EMS transportation of older patients with head injuries to trauma centers; particularly in prospective study designs.

Objective
To determine whether gender differences exist in the transportation of head injured older adults by EMS providers to a trauma center.

Methods
We conducted a prospective multi-center study of injured adults age 55 or older who were transported by EMS to one of four hospitals in a community, one of which is a designated trauma center. Interviews were conducted with each patient’s EMS provider using a standardized survey to assess clinical factors, mechanism of injury, and evidence of head injury. Descriptive statistics were used to characterize the study sample and bivariate and multivariate models were used to assess gender differences according to destination hospital (trauma center vs other hospital).

Results
Data from 894 subjects were analyzed. Median age was 79 years and 57% were female. Transport to a trauma center vs non-trauma center differed significantly by gender, with males being more frequently transported to the trauma center compared to females (51.18% vs. 48.82%; p<0.0002). In unadjusted analyses, female patients had 40% reduced odds of being transported to a trauma center for care compared to males (OR 0.60, 95% CI: 0.46-0.79). After adjusting for age, injury mechanism, and GCS, the results were attenuated, but remained statistically significant (aOR 0.74, 95% CI: 0.55-0.99; p= 0.045).

Conclusion
In our sample, older female patients with head injuries were less frequently transported to a trauma center as compared to males, even when adjusting for other clinical criteria. Reasons for this gender disparity are unknown and require further evaluation.

Summary: Older adults are more likely to be transported to a non-trauma center by prehospital emergency medical services (EMS) compared to younger adults with similar injuries. Little is known about the gender differences in EMS transportation of older patients with head injuries to trauma centers; particularly in prospective study designs.
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