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Major trauma in young and old: what is the difference?
C K van der Sluis1, H J Klasen, W H Eisma
1Department of Rehabilitation Medicine, University Hospital Groningen, The Netherlands.
The Journal of Trauma
|January 1, 1996
Summary
Elderly trauma patients have higher mortality but similar long-term outcomes to younger patients. Severe injuries in the elderly warrant the same intensive care as in younger individuals, despite higher costs.
Area of Science:
- Trauma surgery
- Geriatric medicine
- Critical care medicine
Background:
- Elderly patients often experience worse outcomes after severe injuries.
- Limited data exists on comparative outcomes between young and elderly trauma patients.
Purpose of the Study:
- To compare mortality and long-term functional outcomes in young versus elderly patients with multiple injuries.
- To determine if age alone necessitates different treatment protocols for severe trauma.
Main Methods:
- Retrospective analysis of 288 patients (167 young, 121 elderly) with Abbreviated Injury Scale/Injury Severity Score >= 16.
- Data collected included demographics, injury characteristics, mortality, ventilation, hospitalization, and intensive care duration.
- Long-term outcomes assessed using the Glasgow Outcome Scale.
Main Results:
- Motorized vehicles were the primary cause of injury in both groups.
- Elderly patients had significantly higher mortality (38.8% vs. 19.6%).
- Severe brain injury was the leading cause of death in both age groups; long-term functional outcomes were similar.
Conclusions:
- No evidence suggests elderly trauma patients should be treated differently from younger patients.
- Aggressive trauma care, including intensive care, is justified for severely injured elderly individuals.
- Increased trauma care costs for the elderly are warranted given comparable functional outcomes.