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Blunt chest trauma in the elderly: an expert practice review
Fraser Birse1, Helen Williams2, David Shipway3
1Emergency Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK fraserbirse@gmail.com.
Emergency Medicine Journal : EMJ
|December 14, 2019
Summary
Elderly trauma patients, often presenting after falls, face high risks from thoracic injuries like rib fractures. This review examines current evidence and management strategies for this vulnerable population.
Area of Science:
- Geriatric Medicine
- Trauma Surgery
- Emergency Medicine
Background:
- Trauma in elderly individuals (>65 years) is a growing concern in emergency departments.
- Falls from standing height are the primary cause of trauma presentations in this age group.
- Rib fractures are the most frequent non-spinal fractures observed in elderly trauma patients.
Purpose of the Study:
- To review the current evidence regarding thoracic trauma in elderly patients.
- To discuss clinical management options for this vulnerable demographic.
- To highlight the lack of universally applied guidelines for assessment and treatment.
Main Methods:
- Expert practice review.
- Discussion of existing evidence base.
- Analysis of clinical management options.
Main Results:
- Thoracic injury in individuals over 65 is linked to substantial morbidity and mortality.
- There is a notable absence of standardized guidelines for managing thoracic trauma in the elderly.
- Falls are the predominant mechanism of injury, with rib fractures being common.
Conclusions:
- Elderly patients with thoracic trauma require specific attention due to high associated risks.
- Development and implementation of evidence-based guidelines are crucial for improving outcomes.
- A comprehensive approach to assessment and management is needed for this patient group.
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