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Related Experiment Videos

Morbidity and mortality in elderly trauma patients.

P Tornetta1, H Mostafavi, J Riina

  • 1University Hospital of Brooklyn, New York, USA.

The Journal of Trauma
|April 27, 1999
PubMed
Summary

In elderly trauma patients, higher Injury Severity Score (ISS) and greater need for blood transfusion and fluid resuscitation predict mortality. Orthopedic surgery did not increase mortality risk in this patient group.

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Area of Science:

  • Geriatric Trauma Research
  • Injury Epidemiology
  • Surgical Outcomes in Elderly Patients

Background:

  • Elderly trauma patients face increasing incidence but limited research on mortality predictors.
  • Standard predictors like Injury Severity Score (ISS) may be less effective in older populations.
  • The impact of skeletal injuries on outcomes in elderly trauma patients requires further investigation.

Purpose of the Study:

  • To identify factors predicting morbidity and mortality in elderly blunt trauma patients.
  • To specifically examine the role of skeletal long-bone injuries in elderly trauma outcomes.
  • To analyze a large multicenter dataset for novel insights into geriatric trauma care.

Main Methods:

  • Retrospective review of 326 blunt trauma patients over 60 years old across four Level I trauma centers.

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  • Inclusion criteria: motor vehicle crash, pedestrian struck, fall from height, crush injury (excluding slip-and-fall).
  • Analysis of variables including age, ISS, Glasgow Coma Scale (GCS), transfusion/fluid requirements, surgery type/timing, and complications.

    • Main Results:

    • Mortality rate was 18.1% (59/326 patients).
    • Predictors of mortality included higher ISS, lower GCS score, greater transfusion, and increased fluid resuscitation.
    • Orthopedic surgery alone was associated with lower mortality (OR 0.53); general surgery increased mortality risk (OR 2.5).
    • ISS predicted multiple complications (ARDS, pneumonia, sepsis, GI issues); transfusion predicted myocardial infarction; surgery/transfusion predicted sepsis.
    • Complications were significant risk factors for mortality.

    Conclusions:

    • Mortality in elderly trauma patients is strongly predicted by ISS and associated complications.
    • The timing of orthopedic surgery did not statistically impact complication rates or mortality.
    • Orthopedic surgery in elderly trauma patients was not found to be a risk factor for systemic complications or mortality.