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Comorbidity and the elderly trauma patient

D J McMahon1, C W Schwab, D Kauder

  • 1Division of Traumatology and Surgical Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, 19104, U.S.A.

World Journal of Surgery
|October 1, 1996
PubMed
Summary

Elderly trauma patients require aggressive resuscitation and optimization due to decreased physiologic reserve and comorbidities. Coordinated care addressing both injuries and existing conditions improves outcomes and justifies trauma center triage.

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Area of Science:

  • Geriatric Medicine
  • Trauma Surgery
  • Public Health

Background:

  • Aging populations in developed countries exhibit active lifestyles.
  • Elderly trauma patients present with reduced physiologic reserve and numerous pre-existing medical conditions.
  • These factors contribute to worse outcomes, increased complications, prolonged hospitalization, and higher costs in older adults.

Purpose of the Study:

  • To highlight the unique challenges in managing injured elderly patients.
  • To emphasize the benefits of an aggressive resuscitation and optimization strategy.
  • To underscore the importance of managing concomitant diseases alongside injuries.

Main Methods:

  • Review of current literature on geriatric trauma management.
  • Analysis of factors influencing outcomes in elderly trauma patients.

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  • Discussion of ethical considerations and triage protocols.

    • Main Results:

    • Elderly trauma patients experience poorer outcomes compared to younger counterparts.
    • Early and aggressive cardiopulmonary optimization is crucial.
    • Integrated management of injuries and comorbidities is essential for effective care.
    • Functional decline post-injury can alter social circumstances and raise ethical dilemmas.

    Conclusions:

    • An aggressive, coordinated approach to resuscitation and management of comorbidities in elderly trauma patients improves outcomes.
    • Increased triage to trauma centers is warranted for this population, especially with co-existing conditions.
    • Addressing the complex needs of older trauma patients requires multidisciplinary care and consideration of social and ethical implications.