Prevalence and predictors of low-acuity interfacility transfer in minimal injury severity geriatric trauma patients.

BACKGROUND: Interfacility transfer (IFT) may expose older adults to potentially unnecessary care transitions. METHODS: Using ACS TQIP data (2019-2022), we identified patients aged ≥65 years with Injury Severity Score (ISS) ≤9. Low-acuity transfer required no ICU admission, ventilation, early transfusion, stay >48 h, or unfavorable disposition. Maximum Abbreviated Injury Scale (AIS) severity was summarized by body region. RESULTS: Among 207,875 patients, 54,236 (26.1%) underwent transfer, of whom 7713 (14.2%) met low-acuity criteria. Younger age, male sex, and non-fall mechanism predicted low-acuity transfer; payer disparities persisted. Serious head injury was equally common across acuity groups (head AIS ≥3, 5.8% each), whereas severe lower-extremity injury was less frequent in low-acuity transfers (3.3% vs 25.4%). CONCLUSIONS: Many geriatric transfers involve minimal resource use; while many are clinically justified, this underscores the need for validated, age-specific triage tools incorporating injury phenotype to guide transfer decisions.