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Older polytrauma: Mortality and complications.

Rob de Vries1, Inge H F Reininga2, Max W de Graaf1

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Summary
This summary is machine-generated.

Older adults with polytrauma face higher mortality risks. Key factors include age, coagulopathy, acidosis, low Glasgow coma score, severe head injuries, and overall injury severity, with respiratory failure being a common fatal complication.

Keywords:
ComplicationsElderlyGeriatric traumaMortalityPolytraumaPredisposing factors

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Area of Science:

  • Trauma Surgery
  • Geriatric Medicine
  • Critical Care Medicine

Background:

  • Polytrauma in older adults (≥65 years) is associated with increased mortality.
  • Predisposing factors for mortality in this demographic are not fully understood.
  • In-hospital complications significantly impact outcomes in elderly polytrauma patients.

Purpose of the Study:

  • To investigate the mortality patterns in older polytrauma patients.
  • To identify risk factors associated with in-hospital mortality.
  • To analyze the role and etiology of in-hospital complications in this population.

Main Methods:

  • Retrospective cohort study of 380 polytrauma patients (≥65 years) over eight years.
  • Data linkage with the Dutch Trauma Registry (DTR).
  • Analysis of demographics, injury characteristics, comorbidities, clinical factors, mortality, complications (Clavien-Dindo), and their etiologies.

Main Results:

  • Overall in-hospital mortality was 36.3%, increasing with age (60.8% for ≥85 years).
  • Significant mortality risk factors included advanced age, Glasgow coma score ≤8, coagulopathy, acidosis, injury severity score, and large subdural hematoma.
  • Respiratory failure was the most frequent severe and fatal complication, with its fatality rate increasing with age.

Conclusions:

  • Age is a primary determinant of in-hospital mortality in elderly polytrauma patients.
  • Independent mortality predictors include coagulopathy, acidosis, low Glasgow coma score, large subdural hematoma, and injury severity score.
  • Elderly patients exhibit unique mortality patterns and are more prone to fatal complications, necessitating vigilant pulmonary monitoring and management.