• Jeremy H Levin, Jordan M Estroff, James Zebley, Vince Butano, Ayal Pierce, Armon Panahi, Rich Amdur, and Babak Sarani.
• Department of Surgery, Division of Trauma and Critical Care, George Washington University School of Medicine and Health Sciences, Washington, DC.
• J Emerg Med. 2021 Jul 1; 61 (1): 12-18.

BackgroundThe limitations of resuscitative thoracotomy (RT) after penetrating trauma have been well documented, but there is a paucity of data on the effect age has on mortality. This begs the question as to the utility of RT in an aging patient population. We investigate the significance of age as a predictor for failure to rescue after RT in penetrating trauma.ObjectiveWe sought to identify whether chronologic age has a measurable effect on rates of failure to rescue after RT.MethodsWe performed a retrospective cohort analysis using the Trauma Quality Improvement Program from 2011 to 2015 including all pulseless patients undergoing RT after penetrating injury. Our primary outcome was failure to rescue defined as death in the emergency department after RT. Multivariate analyses were performed to identify the relationship between age and morality controlling for injury severity.ResultsOne thousand one hundred twelve RTs were performed during the study period with an overall failure to rescue rate of 61.8% (n = 687) within the emergency department and an in-hospital mortality rate of 96.9%, which is in line with national data. On univariate analysis, there was no significant association between age and mortality (p = 0.44). On multivariate analysis examining the interaction between age and mortality adjusting for injury severity, we found that chronologic age was not an independent predictor of death after RT.ConclusionsAge does not appear to be an independent predictor of failure to rescue after RT in penetrating trauma and should not be a sole determinant in procedural decision making.Copyright © 2021 Elsevier Inc. All rights reserved.

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