As baby boomers age, medical experts nationwide are tackling the complexity of their care, said Chang. By 2050, about 39 percent of trauma patients will be 65 or older.
"Trauma is often seen as a disease of the young," he said. "But that's changing. You have a fairly active aging population that is playing sports, being active and getting injured."
Age bias itself is difficult to nail down, he said. While emergency medical personnel listed it as a possible factor in surveys, few were willing to elaborate.
"No one ever admits they have a bias - they say they know someone who does something biased," said Chang, who has spent the past two years traveling the state educating emergency medical experts on the disparities. "Basically, it's difficult to get a handle on what bias is. So instead of defining bias, we wanted to show that people behaved differently and find a way to fix the problem."
Chang said anecdotal stories about car crashes where younger patients are taken to trauma centers while older patients go to community hospitals are common.
But the reasons behind such decisions are complex. In some cases, paramedics assume an elderly patient would prefer a familiar hospital where the patient knows the doctors. In a few cases, EMS workers said they were not welcomed by trauma officials when arriving with an elderly patient. And young trauma doctors may perceive an elderly patient's fall as less exciting than a gunshot wound, even though the injuries can be equally severe.
"Sometimes the younger doctors see a person being evaluated, and it turns out to be negative and the patient is sent home," Chang said. "And they think that was a waste of time."
Dealing with elderly trauma patients can prove challenging, said Dr. Thomas M. Scalea, physician in chief at Shock Trauma.
"Part of the problem is everybody's got aches and pains. It's hard to tell: Is that a broken hip or something else?" he said.
For example, an 85-year-old patient who is disoriented after an injury might not be cause for alarm, while a 25-year-with the same symptoms will often strike a doctor as abnormal.
"But they both might have brain injury," Scalea said. "This is much more complicated in older people. There are many issues that make injury in the elderly much more difficult to get your arms around."
Scalea said experts have considered establishing specialized trauma centers for the elderly, similar to centers that exist to treat trauma in children. For now, however, the data should alert experts to the needs of elderly trauma patients, he said.
"If you pick up a medical journal, people like to publish their successes," he said. "But it's important to publish data like this so we can do better."
kelly.brewington@baltsun.com
