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Major trauma outcomes in the elderly

R J Day1, J Vinen, E Hewitt-Falls

  • 1Royal North Shore Hospital, St Leonards, NSW.

The Medical Journal of Australia
|June 6, 1994
PubMed
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Elderly patients with major trauma have a higher mortality rate, especially those over 70 years. However, survivors often regain independence and full function, warranting aggressive treatment.

Area of Science:

  • Geriatric Trauma Care
  • Prognostic Factors in Trauma
  • Elderly Patient Outcomes

Background:

  • Major trauma significantly impacts elderly individuals.
  • Age is a critical factor influencing prognosis after severe injury.

Purpose of the Study:

  • To investigate mortality and functional outcomes in elderly patients experiencing major trauma.
  • To determine the impact of age on the prognosis of elderly trauma survivors.

Main Methods:

  • Retrospective study of 118 patients aged over 60 with injury severity scores > 15.
  • Patients divided into two age groups: 61-70 years and over 70 years.
  • Follow-up for an average of three years, assessing mortality and functional ability using the Barthel index.

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Main Results:

  • In-hospital mortality was 30.5% (36/118).
  • Late mortality was significantly higher in the over 70 group (22 deaths) compared to the 61-70 group (3 deaths) (P < 0.0001).
  • Long-term survivors demonstrated good functional recovery, with most living independently and scoring highly on activities of daily living assessments.

Conclusions:

  • Age is a significant determinant of survival following major trauma.
  • Elderly trauma survivors generally achieve good functional recovery and independence.
  • Aggressive management strategies are recommended for elderly patients with major trauma.