The outcome following major trauma in the elderly. Predictors of survival

Injury ◽  
1999 ◽  
Vol 30 (10) ◽  
pp. 703-706 ◽  
Author(s):  
S.A.W Pickering ◽  
D Esberger ◽  
C.G Moran
Keyword(s):  
Major Trauma ◽  
The Elderly

scholarly journals Medical–legal partnerships: 11 years' experience of providing acute legal advice for critically ill patients and their families

2019 ◽  
Vol 21 (1) ◽  
pp. 40-47
Author(s):  
C. Andrew Eynon ◽  
Lucy J. Robinson ◽  
Kara M. Smith
Keyword(s):  
Critical Illness ◽  
Major Trauma ◽  
The Elderly ◽  
Third Party ◽  
University Hospital ◽  
Legal Service ◽  
Power Of Attorney ◽  
Welfare Benefits ◽  
Legal Advice ◽  
Compensation Claim

Background Medical–legal partnerships integrate lawyers into health care to identify and address legal problems that can create and perpetuate disparities in health for patients and their families. They have previously been utilised for patients who are at high-risk of being disadvantaged such as the elderly, the disabled and those affected by chronic diseases. We have used a partnership to address the legal needs of patients with acute, critical illness including major trauma. Method In 2007, a free, comprehensive legal advice service was established at University Hospital Southampton NHS Foundation Trust. The service is bound by strict guidelines which have been endorsed by NHS England. The legal service is specifically prevented from acting against the NHS. A retrospective analysis of the service over a period of 11 years was undertaken to look at the range of legal advice sought. Where a potential compensation claim against a third party was identified, the percentage of cases where the legal service was instructed was noted and the outcome for those cases was examined in further detail. Results Five hundred and fifty-one patients and or their families have been referred to the legal service. Of these, 343 had sustained major trauma. Over 2300 hours of free legal advice were provided on non-compensation issues, primarily related to welfare benefits, local authority assistance, obtaining power of attorney or seeking Deputyship from the Court of Protection and claims against existing insurance policies. Two hundred and seventy-five of the 551 patients (50%) were found to have a potential compensation claim against a third party. The legal service was instructed to pursue a claim in 82 cases. Interim payments of nearly £13 million were provided and £128 million of compensation has been awarded in 51 cases that have been settled. Discussion Medical–legal partnerships are well-established in the USA. We have demonstrated that in UK, there is a demand for early legal advice for patients who have sustained critical illness including major trauma. More data are required to identify the rehabilitation outcomes for patients who have received legal support. A similar medical–legal partnership should be considered at every acute NHS Trust.

What predicts mortality in the elderly patient presenting as a trauma call? A report from a Major Trauma Centre

The Surgeon ◽  
2020 ◽  
Vol 18 (3) ◽  
pp. 142-149
Author(s):  
Christopher J. Lodge ◽  
Robert M. West ◽  
Peter Giannoudis ◽  
Theodoros H. Tosounidis
Keyword(s):  
Elderly Patient ◽  
Major Trauma ◽  
The Elderly ◽  
Trauma Centre ◽  
Major Trauma Centre

scholarly journals Silver Trauma- a true challenging entity

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
D. Chowdhury
Keyword(s):  
Elderly Patient ◽  
Cervical Spine Injury ◽  
Elderly Population ◽  
Major Trauma ◽  
Management Strategies ◽  
The Elderly ◽  
Spine Injury ◽  
Retirement Age ◽  
Age Group ◽  
Initial Management

Historically trauma has been identified as the leading cause of death in the younger under 40’s population (1). However, with an aging population there is a higher incidence of trauma sustained in the elderly population. Silver trauma is defined as elderly patient of retirement age or over the age of 65 years. This has been taken into consideration when trauma guidelines have been incorporated. To name a few examples, the CCSR (Canadian C-spine rule) includes the at-risk population as those >/= 65 years of age in the context of potential cervical spine injury. In various major trauma trial tools, the >65 years of age group are considered to be a high risk of deteoriation group. Through clinical practice clinicians have noted that in this group of patients’ injuries can be missed which would be detrimental to the overall outcome of these patients. Through this article I aim to highlight the main issues that make the initial management of the elderly trauma patient at times challenging. Furthermore, suggestion for potential management strategies will also be highlighted.

A comparison between the Major Trauma Centre management of complex open lower limb fractures in children and the elderly

Injury ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1376-1381 ◽  
Author(s):  
Muhammad Faheem Khadim ◽  
Ahmed Emam ◽  
Thomas C. Wright ◽  
Thomas W.L. Chapman ◽  
Umraz Khan
Keyword(s):  
Lower Limb ◽  
Major Trauma ◽  
The Elderly ◽  
Trauma Centre ◽  
Lower Limb Fractures ◽  
Fractures In Children ◽  
Major Trauma Centre ◽  
Limb Fractures

scholarly journals Reduced Recovery Capacity After Major Trauma in the Elderly: Results of a Prospective Multicenter Registry-Based Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2356 ◽  
Author(s):  
Viola Freigang ◽  
Karolina Müller ◽  
Antonio Ernstberger ◽  
Marlene Kaltenstadler ◽  
Lisa Bode ◽  
...  
Keyword(s):  
Geriatric Patients ◽  
Major Trauma ◽  
Injury Severity ◽  
The Elderly ◽  
Geriatric Trauma ◽  
Trauma Society ◽  
Recovery Capacity ◽  
Related Quality ◽  
Health Related ◽  
Trauma Injury

Aims: Considering the worldwide trend of an increased lifetime, geriatric trauma is moving into focus. Trauma is a leading cause of hospitalization, leading to disability and mortality. The purpose of this study was to compare the global health-related quality of life (HRQoL) of geriatric patients with adult patients after major trauma. Methods: This multicenter prospective registry-based observational study compares HRQoL of patients aged ≥65 years who sustained major trauma (Injury Severity Score (ISS) ≥ 16) with patients <65 years of age within the trauma registry of the German Trauma Society (DGU). The global HRQoL was measured at 6, 12, and 24 months post trauma using the EQ-5D-3L score. Results: We identified 405 patients meeting the inclusion criteria with a mean ISS of 25.6. Even though the geriatric patients group (≥65 years, n = 77) had a lower ISS (m = 24, SD = 8) than patients aged <65 years (n = 328), they reported more difficulties in each EQ dimension compared to patients <65 years. Contrary to patients < 65, the EQ-5D Index of the geriatric patients did not improve at 12 and 24 months after trauma. Conclusions: We found a limited HRQoL in both groups after major trauma. The group of patients ≥65 showed no improvement in HRQoL from 6 to 24 months after trauma.

Major trauma in the elderly

Trauma ◽  
2009 ◽  
Vol 11 (3) ◽  
pp. 157-161 ◽  
Author(s):  
Som N Sarkar
Keyword(s):  
Major Trauma ◽  
The Elderly

Major trauma outcomes in the elderly

1994 ◽  
Vol 160 (11) ◽  
pp. 675-678 ◽  
Author(s):  
Robert J Day ◽  
John Vinen ◽  
Elizabeth Hewitt‐Falls
Keyword(s):  
Major Trauma ◽  
The Elderly ◽  
Trauma Outcomes

scholarly journals Major trauma in the elderly: Frailty decline and patient experience after injury

Trauma ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Louis Koizia ◽  
Rosalind Kings ◽  
Alexander Koizia ◽  
George Peck ◽  
Mark Wilson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Experience ◽  
Major Trauma ◽  
Injury Severity ◽  
The Elderly ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Post Injury ◽  
Frailty Status

Introduction The prevalence of major trauma in the elderly is increasing with ageing western societies. Frailty is now a well-recognised predictor of poor outcome after injury; however, few studies have focused on the progression of frailty and patients’ perceptions of their injuries after discharge. Aim We hypothesised that the number of elderly patients that survive major trauma is low and, of those that do, frailty post injury worsens with overall negative views about quality of life. To investigate this, we examined mortality, frailty and patient experience for elderly major trauma admissions to a level 1 trauma centre at one year after admission. Method All consecutive patients > 75 with an injury severity score of > 15 were included in the study. Patients were invited to participate in a structured telephone interview to assess change in frailty status as well as assess patient experience after injury. Results A total of 79 patients met inclusion criteria; 34 patients had died and 17 were uncontactable; 88% had become more frail ( p < 0.05), and more than half commented positively on their overall quality of life following injury. Conclusions These findings highlight the elevated mortality in elderly major trauma patients, but also indicate that preconceived opinions on quality of life, post injury, might not be appropriate.

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