Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients
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, Injur...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Journal of Emergencies, Trauma and Shock |
| Subjects: | |
| Online Access: | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2017;volume=10;issue=3;spage=146;epage=150;aulast=Kirshenbom |
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| author | Dvora Kirshenbom Zila Ben-Zaken Nehama Albilya Eva Niyibizi Miklosh Bala |
| author_facet | Dvora Kirshenbom Zila Ben-Zaken Nehama Albilya Eva Niyibizi Miklosh Bala |
| author_sort | Dvora Kirshenbom |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T11:33:19Z |
| format | Article |
| id | doaj.art-708b540f068c4342bb36b1c6eb64da87 |
| institution | Directory Open Access Journal |
| issn | 0974-2700 |
| language | English |
| last_indexed | 2024-12-23T11:33:19Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Emergencies, Trauma and Shock |
| spelling | doaj.art-708b540f068c4342bb36b1c6eb64da872022-12-21T17:48:43ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002017-01-0110314615010.4103/JETS.JETS_62_16Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patientsDvora KirshenbomZila Ben-ZakenNehama AlbilyaEva NiyibiziMiklosh BalaIntroduction: 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.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2017;volume=10;issue=3;spage=146;epage=150;aulast=KirshenbomBlunt traumacomplicationsgeriatric traumainjury severitymortality |
| spellingShingle | Dvora Kirshenbom Zila Ben-Zaken Nehama Albilya Eva Niyibizi Miklosh Bala Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients Journal of Emergencies, Trauma and Shock Blunt trauma complications geriatric trauma injury severity mortality |
| title | Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients |
| title_full | Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients |
| title_fullStr | Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients |
| title_full_unstemmed | Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients |
| title_short | Older age, comorbid illnesses, and injury severity affect immediate outcome in elderly trauma patients |
| title_sort | older age comorbid illnesses and injury severity affect immediate outcome in elderly trauma patients |
| topic | Blunt trauma complications geriatric trauma injury severity mortality |
| url | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2017;volume=10;issue=3;spage=146;epage=150;aulast=Kirshenbom |
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