Correlation of base deficit and age shock index with in-hospital mortality in geriatric major trauma patients: a 1-year retrospective study at a single level I trauma center in Indonesia.

Purpose: Base deficit (BD) and age shock index have been utilized as an indicator of resuscitation adequacy and a predictor of poor outcomes in trauma cases, respectively. However, evidence regarding their correlation with in-hospital mortality among geriatric major trauma patients remains scarce in the literature.

Methods: This analytical observational study employed a retrospective cohort design involving 82 geriatric major trauma patients treated at our institution between November 2023 and November 2024. Data were collected from patients' medical records at admission (age, trauma mechanism, vital signs, Glasgow Coma Scale [GCS], Injury Severity Score, hemoglobin, BD, and comorbidities) and at discharge (survival or death).

Results: The geriatric major trauma patients who experienced in-hospital mortality were predominantly male, with an average age of 69.6 years. Traffic accidents constituted the most common trauma mechanism. Most patients presented with a GCS score between 13 and 15, and hypertension was the most frequently recorded comorbidity. BD demonstrated a significant correlation with in-hospital mortality (P<0.05). Severe BD was associated with the highest odds of in-hospital mortality (adjusted odds ratio, 40.72; 95% confidence interval, 2.90-560.86). Although age shock index did not directly correlate with mortality, it played a confounding role. Additionally, a GCS score of <9 was significantly correlated with in-hospital mortality (P<0.05).

Conclusions: The findings of this study can inform initial clinical management strategies for geriatric major trauma patients at trauma centers. Prompt resuscitation and treatment should be prioritized for patients presenting with moderate or severe BD to reduce preventable mortality in this population.