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Evaluation of geriatric head and neck trauma cases in a German highest-level trauma centre from 2018 to 2024
Ákos Bicsák1,2, Jens-Peter Stahl3,4, Leonie Koch5
1Department of Health, University Witten/Herdecke, Alfred-Herrhausen-Straße 50, Witten, D-58455, Germany. akos.bicsak@gmail.com.
Background:
Geriatric populations face heightened vulnerability due to aging, socioeconomic challenges, and marginalization. In 2023, 18.1% of Germans over 65 were at risk of poverty, with women and those aged 80 + disproportionately affected. The SARS-CoV-2 pandemic (2020-2022) exacerbated these issues, restricting healthcare access. This study investigates geriatric head and neck trauma trends (2018-2024) across pre-pandemic, pandemic, and post-pandemic periods.
Methods:
Conducted at a level 1 trauma centre, data were sourced from the Dortmund Maxillofacial Trauma Registry (14,500 + cases, 2007-2024). Fractures were categorized per AO guidelines, and demographic analyses, fracture distribution and other medical conditions were presented.
Results:
This study analysed 973 geriatric head and neck trauma cases (2018-2024). Falls were predominant (82.6%), with significant comorbidities (2.6 per patient), including hypertension (64%). Males experienced a 73% decrease in case numbers in 2021. Injuries primarily affected the midface, with 52% requiring surgery. Pandemic disruptions influenced trends, highlighting geriatric trauma complexity and care demands are detailed analysed.
Discussion:
Our study presents comprehensive data on geriatric head and neck traumatology, analyzing 65-75 y.o. and > 75 y.o. groups. Male predominance was significant at 65-70 y.o. (p < 0.001) but reversed above 75 y.o., with significant female dominance. Since the SARS-CoV-2 pandemic, case numbers showed extreme volatility, with a 30% rise in females and 90% in males in 2021, followed by a record low in 2022. Cerebral injuries occurred in 49.3% of patients, with 2.6 comorbidities per capita and 52% requiring surgery. Anticoagulant therapy was frequent (≈ 74% antiplatelet, 26% anticoagulant). Falls caused 82% of injuries, predominantly affecting the nasal bone, zygomatic bone (218), and orbital floor (262), indicating high vulnerability in this population.
Conclusion:
Our study reveals volatility in case numbers post-SARS-CoV-2, with males disproportionately affected. A high proportion of elderly patients take anticoagulants. Among the injured, there is a high rate with cerebral injury. Most fractures occur in exposed facial regions. Ongoing surveillance is essential to address increasing geriatric vulnerability.
