Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients: A Multicenter Prospective Observational...

Area of Science:

• Geriatric Trauma Care
• Critical Care Medicine
• Organ Dysfunction Syndromes

Background:

• Older adults represent a growing challenge in trauma care, with recovery often complicated by multiple organ dysfunction syndrome (MODS).
• Predicting MODS in older trauma patients is difficult, as chronological age alone is insufficient, and the factors influencing its development and resolution remain unclear.

Purpose of the Study:

• To investigate the characteristics and outcomes of multiple organ dysfunction syndrome (MODS) specifically in older trauma patients.
• To identify factors associated with the development, recovery, and mortality of MODS in elderly trauma survivors.

Main Methods:

• A prospective study enrolled consecutive adult patients (≥16 years) admitted to major trauma center critical care units.
• Multiple organ dysfunction syndrome (MODS) was defined by a daily Sequential Organ Failure Assessment (SOFA) score exceeding 5.
• Patients were monitored daily until discharge or death.

Main Results:

• The incidence of MODS was high in both younger (<65 years: 64%) and older (≥65 years: 70%) trauma patients.
• Frailty, rather than chronological age, strongly correlated with MODS development (OR, 6.9) and mortality (OR, 2.1).
• Older patients with MODS had significantly higher mortality (28%) compared to younger patients (17%), and non-frail older patients without MODS had better outcomes.

Conclusions:

• Frailty is a key determinant of MODS development, recovery, and outcomes in older trauma patients, overshadowing chronological age.
• Early assessment of frailty in older trauma patients is crucial for predicting MODS and tailoring critical care management.
• Targeting frailty interventions may improve survival and functional recovery in elderly trauma patients experiencing organ dysfunction.