Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul-Sep;10(3):146-150.
doi: 10.4103/JETS.JETS_62_16.

Older Age, Comorbid Illnesses, and Injury Severity Affect Immediate Outcome in Elderly Trauma Patients

Dvora Kirshenbom  1 , Zila Ben-Zaken  1 , Nehama Albilya  1 , Eva Niyibizi  1 , Miklosh Bala  1
Affiliations

Older Age, Comorbid Illnesses, and Injury Severity Affect Immediate Outcome in Elderly Trauma Patients

Dvora Kirshenbom et al. J Emerg Trauma Shock. 2017 Jul-Sep.

Abstract

Introduction: Trauma in elderly population is frequent and is associated with significant mortality, not only due to age but also due to complicated factors such as the severity of injury, preexisting comorbidity, and incomplete general assessment. Our primary aim was to determine whether age, Injury Severity Score (ISS), and preexisting comorbidities had an adverse effect on the outcome in patients aged 65 years and above following blunt trauma.

Methods: We included 1027 patients aged ≥65 years who were admitted to our Level I Trauma Center following blunt trauma. Patients' charts were reviewed for demographics, ISS, mechanism of injury, preexisting comorbidities, Intensive Care Unit and hospital length of stay, complications, and in-hospital mortality.

Results: The mean age of injured patients was 78.8 ± 8.3 years (range 65-109). The majority of patients had mild injury severity (ISS 9-14, 66.8%). Multiple comorbidities (≥3) were found in 233 patients (22.7%). Mortality during the hospitalization stay (n = 35, 3.4%) was associated with coronary artery disease, renal failure, dementia, and warfarin use (P < 0.05). Chronic anticoagulation treatment was recorded in 13% of patients. The addition of a single comorbidity increased the odds of wound infection to 1.29 and sepsis to 1.25. Both age and ISS increased the odds of death as -1.08 and -2.47, respectively.

Conclusions: Our analysis shows that age alone in elderly trauma population is not a robust measure of outcome, and more valuable predictors such as injury severity, preexisting comorbidities, and medications are accounted for adverse outcome. Trauma care in this population with special considerations should be tailored to meet their specific needs.

Keywords: Blunt trauma; complications; geriatric trauma; injury severity; mortality.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Discharge destination distribution in patients’ population
Figure 2
Figure 2
Cause of death in 35 patients. TBI – Traumatic brain injury
Figure 3
Figure 3
Mortality exponentially increased in elder age group (absolute numbers were used)
See this image and copyright information in PMC

References

    1. Moore L, Turgeon AF, Sirois MJ, Lavoie A. Trauma centre outcome performance: A comparison of young adults and geriatric patients in an inclusive trauma system. Injury. 2012;43:1580–5. - PubMed
    1. Aschkenasy MT, Rothenhaus TC. Trauma and falls in the elderly. Emerg Med Clin North Am. 2006;24:413–32, vii. - PubMed
    1. Oreskovich MR, Howard JD, Copass MK, Carrico CJ. Geriatric trauma: Injury patterns and outcome. J Trauma. 1984;24:565–72. - PubMed
    1. Perdue PW, Watts DD, Kaufmann CR, Trask AL. Differences in mortality between elderly and younger adult trauma patients: Geriatric status increases risk of delayed death. J Trauma. 1998;45:805–10. - PubMed
    1. Osler T, Hales K, Baack B, Bear K, Hsi K, Pathak D, et al. Trauma in the elderly. Am J Surg. 1988;156:537–43. - PubMed