Blunt chest trauma in older vs. Non-elderly adults: outcomes and management

Blunt chest trauma (BCT) substantially contributes to morbidity and mortality globally, especially in elderly adults. Most studies on BCT in older adults were conducted in Western countries, not reflecting regional differences. The study aimed to examine the incidence, injury patterns, management, and outcomes of BCT in older adults in the United Arab Emirates (UAE).

Data of patients aged ≥60 years with BCT admitted to a community-based hospital in 2014-2020 were retrospectively analyzed, including age, sex, nationality, mechanism of injury, vital signs, associated injuries, severity scales, hospitalization length, intensive care unit admission, ICU length of stay, management, and outcomes.

Of 861 patients assessed, 73 (8.5%) were aged ≥60 years. The most common mechanism of trauma was road traffic collisions (RTC; 51, 69.9%), followed by falling from height ≤1 meter (10, 13.7%). The most common thoracic injury was multiple rib fractures (25, 34.2%), whereas spine injury was the most common extrathoracic injury (25, 34.2%). Pulmonary contusion was significantly less frequent in older patients compared to younger adults with BCT (P = 0.004). Female sex and UAE national patients were significantly more frequent among older adults compared to younger adults with BCT (P < 0.001 and P = 0.002). Falls from a height of ≤1 meter were also significantly more common in older patients.

Despite reduced occupational exposure and lower engagement in high-risk activities, RTC remain a major cause of BCT in elderly populations. Although many falls are low-energy events, their high incidence makes them a frequent contributor to the overall BCT burden in the elderly.