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Vessel-sparing Excision and Primary Anastomosis
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Outcomes in geriatric genitourinary trauma.

Marc A Bjurlin1, Sandra M Goble, Richard J Fantus

  • 1Division of Urology, Department of Surgery, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL 60612, USA.

Journal of the American College of Surgeons
|July 5, 2011
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Geriatric trauma patients (GTPs) experience more genitourinary (GU) injuries, with higher ICU admissions and mortality rates compared to younger patients. Despite similar injury severity, GTPs face worse outcomes, highlighting a need for specialized care.

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Area of Science:

  • Trauma Surgery
  • Geriatric Medicine
  • Urology

Background:

  • Geriatric trauma patients (GTPs) represent a growing demographic in trauma centers.
  • Understanding genitourinary (GU) trauma in GTPs is crucial due to their increasing prevalence.

Purpose of the Study:

  • To compare the characteristics and outcomes of GU trauma in geriatric trauma patients (GTPs) versus nongeriatric trauma patients (NGTPs).

Main Methods:

  • Analysis of the National Trauma Data Bank v8.0 using ICD-9 CM codes for GU injuries.
  • Comparison of GTPs (≥65 years) with NGTPs (18-64 years) on injury patterns, severity, interventions, comorbidities, complications, and mortality.
  • Statistical analysis using chi-square and t-tests to compare categorical and continuous variables.

Main Results:

  • GTPs showed higher rates of bladder/urethral injuries but lower rates of penile/scrotal injuries compared to NGTPs.
  • While Injury Severity Scores were similar, GTPs had increased ICU admissions and longer ICU stays.
  • GTPs experienced significantly more comorbidities and hospital complications, with a mortality rate nearly double that of NGTPs.

Conclusions:

  • Geriatric trauma patients sustain a substantial burden of genitourinary injuries.
  • Despite comparable injury severity scores, GTPs exhibit poorer outcomes, including higher mortality.
  • Penetrating GU trauma is less frequent in GTPs, with blunt trauma being more common.