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Multisystem geriatric trauma

S P Zietlow1, P J Capizzi, M P Bannon

  • 1Department of Surgery, Mayo Clinic, Rochester, MN 55905.

The Journal of Trauma
|December 1, 1994
PubMed
Summary
This summary is machine-generated.

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Elderly patients with multisystem trauma face high mortality, often from severe head injuries within 24 hours. Survivors achieve good functional status, but reimbursement doesn't match care costs.

Area of Science:

  • Trauma Surgery
  • Geriatric Medicine
  • Public Health

Background:

  • Elderly individuals represent a significant portion of trauma admissions.
  • Multisystem trauma in older adults presents unique challenges in management and outcomes.
  • Understanding the specific needs and outcomes of this demographic is crucial for improving care.

Purpose of the Study:

  • To analyze the demographics of elderly patients with multisystem trauma.
  • To evaluate the hospital course, functional outcomes, and reimbursement associated with this patient group.
  • To identify factors influencing mortality and long-term recovery in older trauma patients.

Main Methods:

  • Retrospective review of the Trauma Registry for patients aged 65 and older with an Injury Severity Score (ISS) of 10 or higher.

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  • Data collection included hospital course, reimbursement information, and a 12-month follow-up telephone survey.
  • Analysis focused on demographics, injury patterns, mortality predictors, and functional status at discharge and follow-up.

    • Main Results:

    • Out of 1931 trauma patients, 94 met the criteria (31% were >65 years old).
    • Mortality rate was 23%, with most deaths occurring within 24 hours, primarily due to severe closed head injury (CHI).
    • Over half of survivors returned home with independent functional status at 12-month follow-up, despite an average hospital stay of 10 days.

    Conclusions:

    • Multisystem trauma in the elderly is associated with high mortality, particularly from severe CHI.
    • A significant proportion of survivors regain independence, highlighting the potential for recovery.
    • Current reimbursement levels do not adequately reflect the cost of care or the functional outcomes achieved for these patients.