Polytrauma in the elderly

Abstract

As the elderly population grows, a concomitant increase in polytrauma in the geriatric sector is predicted. Diminished physiologic reserve and deficiencies in management contribute to higher rates of morbidity and mortality in the elderly patient with trauma as compared with the young patient with equivalent trauma. Currently, traditional trauma scoring systems are insufficient in directing triage and predicting survival for these elderly patients. This may be related to the effects of aging and associated comorbidities. Age, therefore, should be considered in contemporary scoring systems and treatment algorithms. The benefits of prompt identification and treatment of musculoskeletal, neurologic, abdominal, and cardiopulmonary trauma, and maintenance of adequate nutritional status are well established in the polytrauma setting, in general. For the elderly patient with polytrauma, early invasive hemodynamic and cardiac monitoring are advisable to identify occult shock, limit end organ hypoperfusion, prevent multiorgan failure, and ultimately improve survival.