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We aimed to examine acute trauma outcomes, specifically among those with neurotrauma (NT), in patients with preexisting cerebrovascular accident (CVA). We identified patients treated for neurotrauma or orthopedic trauma at hospitals in Pennsylvania with and without an identified history of stroke with residual deficits, aged 50–99 across four groups of N = 11,648 each. We assessed mortality, craniotomy, and total hospital, ICU, step-down, and ventilator days, functional status at discharge (FSD), and discharge destination. Stroke history did not influence mortality but was predictive of patients undergoing craniotomy (OR = 1.25,  p  = 0.008). There was a moderate group effect on total ICU days, with the CVA+NT group in the ICU the longest (η2 = 0.10,  p  &lt; 0.001). Patients with stroke history were less likely to be discharged to home (OR = 0.65,  p  &lt; 0.001) and had poorer FSD scores across the various domains assessed. Trauma patients with preexisting CVA were found to have poorer outcomes on a number of different metrics when compared to those without stroke history. While it is possible that functional differences pre-injury influenced FSD and discharge destination, given these results, clinicians should assess for possible comorbidities that may influence treatment.

Effects of preexisting stroke on acute hospital outcomes for older adults admitted with neurotrauma and orthopedic injury