Preexisting medical problems in the trauma patient: do they matter?

The answer to the question posed by the title of this chapter (preexisting medical problems in the trauma patient: do they matter?) has by now become obvious. The type and severity of the initial injury are the major determinants of outcome. Trauma prevention is therefore a compelling social goal. Skillful and timely resuscitation efforts favorably affect survival statistics. Even though detailed outcome data do not yet exist in all areas regarding pre-existing illness, it is clear that underlying disease may directly cause trauma, may necessitate modification in trauma management, and may even adversely effect the health-care providers themselves.