Factors Influencing Geriatric Orthopaedic Trauma Mortality

Area of Science:

• Geriatric Trauma
• Orthopaedic Surgery
• Intensive Care Medicine

Background:

• Geriatric trauma patients admitted to the ICU present unique challenges.
• Understanding survival predictors is crucial for optimizing care.

Purpose of the Study:

• To identify independent risk factors for survival and mortality in geriatric orthopaedic trauma patients.
• To develop a predictive model for survival in this population.

Main Methods:

• Retrospective review of patients over 60 with multi-trauma and orthopaedic injuries over 10 years.
• Analysis of variables including Injury Severity Score (ISS), comorbidities, ICU interventions, and mortality.
• Kaplan-Meier estimator and Cox proportional hazards analysis for survival prediction.

Main Results:

• 174 patients included; average mortality was 47.7%.
• Higher age, ISS, vasopressor use, ICU stay, Multiple Organ Dysfunction Syndrome (MODS), genitourinary disease, anticoagulant use, and ventilator use were associated with increased mortality.
• ISS >30 was a strong predictor of lower survival; genitourinary disease also increased mortality risk.

Conclusions:

• An ISS >30 is a critical indicator of reduced survival probability in geriatric orthopaedic trauma patients.
• Factors like older age, higher ISS, prolonged ICU stay, MODS, anticoagulant use, and ventilator use predict poorer survival.
• While specific orthopaedic injury characteristics were not predictive, understanding these broader factors aids in better diagnosis and care.