scholarly journals Retrospective Analysis of Geriatric Major Trauma Patients Admitted in the Shock Room of a Swiss Academic Hospital: Characteristics and Prognosis

2020 ◽  
Vol 9 (5) ◽  
pp. 1343
Author(s):  
Monica Pagin ◽  
Cédric Mabire ◽  
Michael Cotton ◽  
Tobias Zingg ◽  
Pierre-Nicolas Carron
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Major Trauma ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Main Diagnosis ◽  
Statistical Regression ◽  
Specific Patient ◽  
Anti Platelet Therapy ◽  
Main Factors

Increased life expectancy exposes a great number of elderly people to serious accidents, thus increasing the amount of major geriatric trauma cases. The aim of our study was to determine the profile of elderly patients undergoing major trauma, and the contributing factors predicting mortality in this specific patient group, compared to the younger population. Retrospective analysis of 1051 patients with major trauma admitted over ten years in a Level-1 trauma center was performed. Data collected were: history, nature and type of trauma; age and sex; vital signs on admission; injury severity score; shock index; comorbidities; coagulation diathesis; injury patterns; emergency measures taken; main diagnosis; mortality; and length of hospital and intensive care unit (ICU) stay. Geriatric patients admitted for major trauma have a mortality rate almost four times greater (47%) than their younger counterparts (14%) with the same ISS. According to statistical regression analysis, anti-platelet therapy (OR 3.21), NACA (National Advisory Committee for Aeronautics) score (OR 2.23), GCS (OR 0.83), ISS (OR 1.07) and age (OR 1.06) are the main factors predicting mortality. Conclusion: Geriatric major trauma patients admitted to our trauma resuscitation area have a high mortality rate. Age, GCS, ISS and NACA scores as well as anti-platelet therapy are the main factors predicting mortality.

Geriatric Trauma Patients at a Suburban Level-I Trauma Center in Japan

1999 ◽  
Vol 14 (3) ◽  
pp. 79-83 ◽  
Author(s):  
Katsuhiko Sugimoto ◽  
Toru Aruga ◽  
Mitsuhiro Hirata ◽  
Masateru Shindo
Keyword(s):  
Mortality Rate ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Geriatric Trauma ◽  
Control Group ◽  
Trauma Patients ◽  
Direct Transfer ◽  
Emergency Center ◽  
Revised Trauma Score ◽  
Trauma Score

AbstractBackground:Despite the increases in the aged population in Japan, there are little data on geriatric patients with traumatic injuries. A prospective clinical study was carried out to evaluate the use of the emergency medical services (emergency medical services) system, mechanisms of injury, and prehospital assessment and triage of elderly victims of trauma.Patients and Methods:From July 1996 through June 1997, a group of geriatric trauma (Group G, n = 22) and a control group of younger trauma patients (n = 173) were compared with respect to transfer method to an Emergency Center (direct or indirect), Revised Trauma Scores on the scene of the accident (revised trauma score-l) and on admission to the Emergency Center (revised trauma score-2), and outcome (survival).Results:The mean values for revised trauma score-l in the Control Group (Group C) were not different from those in Group G, but revised trauma score-2 of the indirect-transfer patients (indirectly transported patients) in Group G were significantly lower than were those for Group C. Group G mortality rates were significantly higher than were the control rates (p = 0.0001). The mortality rate of the indirectly transported patients subgroup was significantly lower than that of the direct transfer subgroup (directly transported patients) (30/68 vs. 5/70, p<0.0001) in the Group C, but mortality rate of the indirectly transported patients subgroup exceeded that of the directly transported patients subgroup of Group G (8/14 vs. 5/8).Conclusion:The data suggest that in geriatric-age patients, direct transfer patients have a lower mortality rate than do indirect transfer patients when controlled for injury severity score. Therefore, it seems that a different set of triage criteria should be developed and implemented for geriatric-age victims with trauma-induced injuries and that those who meet these more stringent criteria should be transferred directly to a Trauma Center.

Unseen Burden of Injury: Post-Hospitalization Mortality in Geriatric Trauma Patients

2021 ◽  
pp. 000313482110468
Author(s):  
Ciara R. Huntington ◽  
Angela M. Kao ◽  
Ronald F. Sing ◽  
Samuel W. Ross ◽  
A. Britt Christmas ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Social Security ◽  
Trauma Center ◽  
Older Patients ◽  
Motor Vehicle ◽  
Geriatric Trauma ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Social Security Death Index

Background/Objectives Older adults are at risk for adverse outcomes after trauma, but little is known about post-acute survival as state and national trauma registries collect only inpatient or 30-day outcomes. This study investigates long-term, out-of-hospital mortality in geriatric trauma patients. Methods Level I Trauma Center registry data were matched to the US Social Security Death Index (SSDI) to determine long-term and out-of-hospital outcomes of older patients. Blunt trauma patients aged ≥65 were identified from 2009 to 2015 in an American College of Surgeons Level 1 Trauma Center registry, n = 6289 patients with an age range 65-105 years, mean age 78.5 ± 8.4 years. Dates of death were queried using social security numbers and unique patient identifiers. Demographics, injury, treatments, and outcomes were compared using descriptive and univariate statistics. Results Of 6289 geriatric trauma patients, 505 (8.0%) died as an inpatient following trauma. Fall was the most common mechanism of injury (n = 4757, 76%) with mortality rate of 46.5% at long-term follow-up; motor vehicle crash (MVC) (n = 1212, 19%) had long-term mortality of 27.6%. Overall, 24.1% of patients died within 1 year of trauma. Only 8 of 488 patients who died between 1 and 6 months post-trauma were inpatient. Mortality rate varied by discharge location: 25.1% home, 36.4% acute rehabilitation, and 51.5% skilled nursing facility, P < .0001. Conclusion Inpatient and 30-day mortality rates in national outcome registries fail to fully capture the burden of trauma on older patients. Though 92% of geriatric trauma patients survived to discharge, almost one-quarter had died by 1 year following their injuries.

The psoas muscle index as a predictor of mortality and morbidity of geriatric trauma patients: experience of a major trauma center in Kobe

Surgery Today ◽  
2020 ◽  
Vol 50 (9) ◽  
pp. 1016-1023 ◽  
Author(s):  
Takeshi Nishimura ◽  
Hiromichi Naito ◽  
Noritomo Fujisaki ◽  
Satoshi Ishihara ◽  
Atsunori Nakao ◽  
...  
Keyword(s):  
Trauma Center ◽  
Major Trauma ◽  
Psoas Muscle ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Mortality And Morbidity ◽  
Patients Experience

The Impact of Enhanced Intensive Care on Outcome of Major Trauma Patients in a Regional Hospital in Hong Kong

2008 ◽  
Vol 15 (4) ◽  
pp. 218-229
Author(s):  
ANL Chan ◽  
ACH Lit
Keyword(s):  
Hong Kong ◽  
Intensive Care ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Major Trauma ◽  
Injury Severity ◽  
Regional Hospital ◽  
Blunt Injury ◽  
Trauma Patients ◽  
The Impact

Objectives To describe an updated epidemiology of major trauma cases presenting to a regional hospital in Hong Kong and to analyse the impact of enhanced intensive care on the outcome of major trauma patients. Methods This was a retrospective comparative study. In late 2004, we amended our trauma care system with enhancement of intensive care in the management of major trauma patients. An 18-month period was chosen before and after the amendment respectively and patients' data and crude mortality rate between the two periods were compared. Stratified analyses based on mechanism of injury, injury severity and physiological parameters were also performed. Finally, a TRISS analysis was included. Results Altogether 163 and 155 patients were included in our study from the two periods respectively. The majority involved blunt injury and one third of them had injury severity score (ISS) greater than 15. Road traffic accidents and fall from height remained as the two leading causes of major trauma. The median length of stay in the intensive care unit increased for one day (p<0.01) in the later period but the median total length of stay in hospital remained the same. The mortality rate decreased from 10.4% to 9.7% (p=0.82). Conclusion With enhanced intensive care, there is an apparent decrease in mortality of major trauma patients but its significance needs to be determined with a larger scale study.

Long-term survival after major trauma in geriatric trauma patients

2012 ◽  
Vol 72 (5) ◽  
pp. 1181-1185 ◽  
Author(s):  
Michael D. Grossman ◽  
Ulunna Ofurum ◽  
Christy D. Stehly ◽  
Jill Stoltzfus
Keyword(s):  
Major Trauma ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Comprehensive Comparison Between Geriatric and Nongeriatric Patients With Trauma

2021 ◽  
Author(s):  
Pei-Chen Lin ◽  
Nan-Chun Wu ◽  
Hsiu-Chen Su ◽  
Chien-Chin Hsu ◽  
Kuo-Tai Chen
Keyword(s):  
Mortality Rate ◽  
Geriatric Patients ◽  
Long Term Care ◽  
Global Perspective ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Term Care ◽  
Severity Scores ◽  
Poor Outcomes

Abstract Purpose:The incidence of geriatric trauma is increasing due to the growing elderly population. Healthcare providers require a global perspective to differentiate critical factors that might alter patients’ prognosis.Methods: We retrospectively reviewed all adult patients admitted to a trauma center during a 4-year period. We identified 655 adult trauma patients aged from 18 to 64 (nongeriatric group) and 273 trauma patients ≥65 years (geriatric group). Clinical data were collected and compared between the two groups. Results:The geriatric group had a higher incidence of trauma and higher Injury Severity Scores than did the nongeriatric group. Fewer geriatric patients underwent surgical treatment (all patients: geriatric vs. nongeriatric: 65.9% vs. 70.7%; patients with severe trauma: geriatric vs. nongeriatric: 27.6% vs. 44.5%). Regarding prognosis, the geriatric group exhibited higher mortality rate and less need for long-term care (geriatric vs. nongeriatric: mortality: 5.5% vs. 1.8%; long-term care: 2.2% vs. 5.0%). Conclusion:We observed that geriatric patients had higher trauma incidence and higher trauma mortality rate. Aging is a definite predictor of poor outcomes for trauma patients. Limited physiological reserves and preference for less aggressive treatment might be the main reasons for poor outcomes in elderly individuals.

scholarly journals Implementation of new standard operating procedures for geriatric trauma patients with multiple injuries: a single level I trauma centre study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lorenz Peterer ◽  
Christian Ossendorf ◽  
Kai Oliver Jensen ◽  
Georg Osterhoff ◽  
Ladislav Mica ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Life Support ◽  
Standard Operating Procedures ◽  
Geriatric Trauma ◽  
Whole Body ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Severely Injured ◽  
Standard Operating ◽  
Injured Patients

Abstract Background The demographic changes towards ageing of the populations in developed countries impose a challenge to trauma centres, as geriatric trauma patients require specific diagnostic and therapeutic procedures. This study investigated whether the integration of new standard operating procedures (SOPs) for the resuscitation room (ER) has an impact on the clinical course in geriatric patients. The new SOPs were designed for severely injured adult trauma patients, based on the Advanced Trauma Life Support (ATLS) and imply early whole-body computed tomography (CT), damage control surgery, and the use of goal-directed coagulation management. Methods Single-centre cohort study. We included all patients ≥65 years of age with an Injury Severity Score (ISS) ≥ 9 who were admitted to our hospital primarily via ER. A historic cohort was compared to a cohort after the implementation of the new SOPs. Results We enrolled 311 patients who met the inclusion criteria between 2000 and 2006 (group PreSOP) and 2010–2012 (group SOP). There was a significant reduction in the mortality rate after the implementation of the new SOPs (P = .001). This benefit was seen only for severely injured patients (ISS ≥ 16), but not for moderately injured patients (ISS 9–15). There were no differences with regard to infection rates or rate of palliative care. Conclusions We found an association between implementation of new ER SOPs, and a lower mortality rate in severely injured geriatric trauma patients, whereas moderately injured patients did not obtain the same benefit. Trial registration Clinicaltrials.gov NCT03319381, retrospectively registered 24 October 2017.

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