A. J. Nastasi1,2, J. K. Canner1, B. D. Lau1, M. B. Streiff3, J. K. Aboagye1, K. J. Van Arendonk1, P. S. Kraus6, D. B. Hobson5, D. Shaffer5, E. R. Haut1,4 1Johns Hopkins University,Surgery,Baltimore, MD, USA 2Johns Hopkins University,Epidemiology,Baltimore, MD, USA 3Johns Hopkins University,Hematology,Baltimore, MD, USA 4Johns Hopkins University,Health Policy And Management,Baltimore, MD, USA 5Johns Hopkins University,Nursing,Baltimore, MD, USA 6Johns Hopkins University,Pharmacy,Baltimore, MD, USA
Introduction:
Venous thromboembolism (VTE) is a great burden in trauma; however, current guidelines lack recommendations regarding the prevention of VTE in older adult trauma patients. Furthermore, the appropriate method of modeling age in VTE models is currently unclear.
Methods:
3,598,881 patients between the years 2008 and 2014 in the National Trauma Data Bank (NTDB) and 505,231 patients between 2009-2013 from the National Inpatient Sample (NIS) were analyzed. Multiple logistic regression of VTE on age was performed. Based on unadjusted VTE incidence, age was modeled as a linear spline with a knot at age 65.
Results:
In the NTDB, 34,202 (0.95%) patients were diagnosed with VTE while 1,709,881 (47.5%) patients were ≥65 years. In both the fully adjusted NTDB and NIS model, age was positively associated with VTE incidence until age 65 (NTDB: aOR 1.018, 95% CI 1.017 – 1.019, p < 0.001; NIS: aOR 1.025, 95% CI 1.022 – 1.027, p < 0.001). In patients ≥65 years, age was inversely associated with VTE in the NTDB model (aOR 0.995, 95% CI 0.992 – 0.999, p = 0.006) and not associated with VTE risk in the NIS model (aOR 0.998, 95% CI 0.994 – 1.002, p = 0.26).
Conclusion:
VTE risk in adult trauma patients appears to steadily increase with age until 65 years, after which risk appears to level off or even slightly decrease. These findings should be considered when creating standardized guidelines for VTE prevention in older adults as well when modeling age in VTE models of adult trauma patients.
