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. 2023 Nov 15;8(6):112.
doi: 10.3390/geriatrics8060112.

Hand Trauma in Emergency Department Management in Older Adults ≥ 80 Years Old: A Twenty-Year Retrospective Analysis

Camillo Fulchignoni  1 , Marcello Covino  2 , Silvia Pietramala  1 , Ivo Lopez  1 , Gianfranco Merendi  1 , Andrea De Matthaeis  3 , Francesco Franceschi  2 , Giulio Maccauro  3 , Lorenzo Rocchi  1
Affiliations

Hand Trauma in Emergency Department Management in Older Adults ≥ 80 Years Old: A Twenty-Year Retrospective Analysis

Camillo Fulchignoni et al. Geriatrics (Basel). .

Abstract

The prevalence of hand injuries increases with age, with elderly patients being more prone to hand lesions due to a combination of factors, such as reduced bone density and muscle strength, impaired sensation, and cognitive impairment. Despite the high incidence of hand injuries in the elderly population, few studies have addressed the management and outcomes of hand lesions in this age group. This study aimed to analyze the characteristics and management of hand lesions in patients over 80 years old. The authors conducted a retrospective analysis of medical records of patients over 80 years old who reached their Emergency Department with hand lesions between 2001 and 2020. Data on demographics, injury characteristics, and management were collected and analyzed. A total of 991 patients with hand lesions were included in the study, with a mean age of 84.9 years. The most common causes of injuries were domestic accidents (32.6%) and traffic accidents (12.8%). The most frequent types of hand lesions were fractures (23.5%) and superficial wounds (20.5%). Overall, 23.4% underwent surgical treatment for their hand issue, and 22.1% had associated injuries, among which, the most common were head trauma and other bone fractures. In conclusion, hand lesions in patients over 80 years old are frequent and pose significant challenges in diagnosis and management. Particular attention should be paid to associated injuries and limit indications to surgery when strictly necessary.

Keywords: associated injuries; elderly; emergency department; hand surgery; patient admission.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Associated injuries. Numbers in brackets represent absolute counts of patients with the specific type of associated injury; numbers in the chart represent percentages.
Figure 2
Figure 2
Evolution of the number of patients over 80 years old reaching the ED for a hand problem. Numbers in abscissae and in the graph represent the absolute number of patients; values in ordinates represent the period of time taken into account.
Figure 3
Figure 3
Evolution over time of severity of lesions (by triage code color) in percentages. White (not urgent, should be assessed within 240 min), green (minor urgency, should be assessed within 120 min), yellow (urgency, should be assessed within 30 min), and red (emergency, should be assessed immediately).
See this image and copyright information in PMC

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