Epidemiology and outcomes of geriatric patients with severe injury in Korea: Nationwide community-based study, 2016-2023.
Injury · 2026-06-13 · Registry study
Abstract
INTRODUCTION: As the number of geriatric populations increases in the aging era, the injury of the older adults is also increasing. This study aimed to investigate the epidemiologic trends and injury characteristics of geriatric patients with severe injuries by age groups and mechanism, using a nationwide database in Korea. MATERIALS AND METHODS: A cross-sectional observational study was conducted for all emergency medical service (EMS) treated geriatric (≥65 years) patients with severe injuries in Korea between 2016 and 2023. Patients who met the criteria for a field-based injury triage scheme or had a prehospital physiologic abnormality were defined as severe injury. Exposure was age group: young old (65-74), middle old (75-84), and oldest old (≥85 years) groups. The distribution of age groups was investigated by year. Injury characteristics and outcomes were compared by age group and mechanism. A Multivariable logistic regression analysis was used to investigate the predictors of mortality of geriatric patients with severe injuries. RESULTS: Among 319,567 patients with severe injuries transferred by EMS over 8 years, 92,085 (28.8%) were over 65 years of age. The proportion of older adults increased from 25.7% in 2016 to 32.0% in 2023. Among older adults, young old was 46.4% (42,742), middle old was 39.3% (36,182), and oldest old was 14.3% (13,161). The proportion of oldest old increased from 11.8% in 2016 to 16.6% in 2023. Most common mechanisms were slip/fall (35.9%), traffic accident (TA) (30.1%), and poisoning (17.4%) and 17.0% were suicidal attempts. Overall hospital mortality was 27.9% and the older the age, the higher mortality (young 25.2%, middle 30.0%, and oldest 31.0%). As age group increased, slip/fall increased (33.2% to 46.4%) and TA decreased (34.3% to 15.3%). Older age groups, male, suicidal attempts, and TA and asphyxia (compared with slip/fall) were associated with higher risk of hospital mortality. CONCLUSIONS: The geriatric patients, especially the oldest old with high mortality are increasing among patients with severe injuries. It is necessary to plan target-specific geriatric injury prevention program based on age distribution and common injury mechanism.