Polytrauma in the elderly: a review

Abstract

Although the field of geriatric trauma is - ironically - young, care for the elderly trauma patient is increasingly recognised as an important challenge, considering the worldwide trend towards increasing longevity.Increasing age is associated with physiological changes and resulting comorbidities that present multiple challenges to the treating physician.Even though polytrauma is less likely with increasing age, lower-energy trauma can also result in life-threatening injuries due to the reduced physiological reserve.Mechanisms of injury and resulting injury patterns are markedly changed in the elderly population and new management strategies are needed. From initial triage to long-term rehabilitation, these patients require care that differs from the everyday standard.In the current review, the special requirements of this increasing patient population are reviewed and management options discussed. With the increase in orthogeriatrics as a speciality, the current status quo will almost certainly shift towards a more tailored treatment approach for the elderly patient. Further research expanding our current knowledge is needed to reduce the high morbidity and mortality rate. Cite this article: Braun BJ, Holstein J, Fritz T, Veith NT, Herath S, Mörsdorf P, Pohlemann T. Polytrauma in the elderly: a review. EFORT Open Rev 2016;1:146-151. DOI: 10.1302/2058-5241.1.160002.

Keywords: comorbidities; elderly; orthogeriatrics; polytrauma.

Fig. 1

Seventy-six year old male polytrauma patient with Le Fort III fracture (a, b), severe lung contusion (c) and tibia shaft fracture (d). Treatment was performed with nail (e) and plate osteosyntheses (f).

Fig. 2

Body regions with the most severe injuries, as reported by Richmond et al in over 35 000 injured elderly persons.