Are There Any Red Flag Injuries in Severely Injured Patients in Older Age?
Introduction: Severely injured elderly patients pose a significant burden to trauma centers and, compared with younger patients, have worse prognoses and higher mortality rates after major trauma. The objective of this study was to identify the etiological mechanisms that are associated with severe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/2/185 |
| _version_ | 1797415638744956928 |
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| author | Daniel Popp Borys Frankewycz Siegmund Lang Antonio Ernstberger Volker Alt Michael Worlicek Maximilian Kerschbaum |
| author_facet | Daniel Popp Borys Frankewycz Siegmund Lang Antonio Ernstberger Volker Alt Michael Worlicek Maximilian Kerschbaum |
| author_sort | Daniel Popp |
| collection | DOAJ |
| description | Introduction: Severely injured elderly patients pose a significant burden to trauma centers and, compared with younger patients, have worse prognoses and higher mortality rates after major trauma. The objective of this study was to identify the etiological mechanisms that are associated with severe trauma in elderly patients and to detect which injuries correlate with high mortality in elderly patients. Methods: Using a prospect cohort study model over an 11-year period, severely injured patients (ISS ≥ 16) were divided into two age groups (Group 1: 18–64; Group 2: 65–99 years). A comparison of the groups was conducted regarding injury frequency, trauma mechanism, distribution of affected body parts (AIS and ISS regions) and injury related mortality. Results: In total, 1008 patient were included (Group 1: <i>n</i> = 771; Group 2: <i>n</i> = 237). The most relevant injury in elderly patients was falling from low heights (<3 m) in contrast to traffic accident in young patients. Severely injured patients in the older age group showed a significantly higher overall mortality rate compared to the younger group (37.6% vs. 11.7%; <i>p</i> = 0.000). In both groups, the 30-day survival for patients without head injuries was significantly better compared to patients with head injuries (92.7% vs. 85.3%; <i>p</i> = 0.017), especially analyzing elderly patients (86.6% vs. 58.6%; <i>p</i> = 0.003). The relative risk of 30-day mortality in patients who suffered a head injury was also higher in the elderly group (OR: Group 1: 4.905; Group 2: 7.132). Conclusion: In contrast to younger patients, falls from low heights (<3 m) are significant risk factors for severe injuries in the geriatric collective. Additionally, elderly patients with an ISS ≥ 16 had a significantly higher mortality rate compared to severe injured younger patients. Head injuries, even minor head traumata, are associated with a significant increase in mortality. These findings will contribute to the development of more age-related therapy strategies in severely injured patients. |
| first_indexed | 2024-03-09T05:51:30Z |
| format | Article |
| id | doaj.art-b12afebb57ee45d7b08e92f42e84c971 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:51:30Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b12afebb57ee45d7b08e92f42e84c9712023-12-03T12:17:06ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-0110218510.3390/jcm10020185Are There Any Red Flag Injuries in Severely Injured Patients in Older Age?Daniel Popp0Borys Frankewycz1Siegmund Lang2Antonio Ernstberger3Volker Alt4Michael Worlicek5Maximilian Kerschbaum6Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyDepartment of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyDepartment of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyDepartment of Trauma and Hand Surgery, Hospital Osnabrück, 49076 Osnabrück, GermanyDepartment of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyDepartment of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyDepartment of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, GermanyIntroduction: Severely injured elderly patients pose a significant burden to trauma centers and, compared with younger patients, have worse prognoses and higher mortality rates after major trauma. The objective of this study was to identify the etiological mechanisms that are associated with severe trauma in elderly patients and to detect which injuries correlate with high mortality in elderly patients. Methods: Using a prospect cohort study model over an 11-year period, severely injured patients (ISS ≥ 16) were divided into two age groups (Group 1: 18–64; Group 2: 65–99 years). A comparison of the groups was conducted regarding injury frequency, trauma mechanism, distribution of affected body parts (AIS and ISS regions) and injury related mortality. Results: In total, 1008 patient were included (Group 1: <i>n</i> = 771; Group 2: <i>n</i> = 237). The most relevant injury in elderly patients was falling from low heights (<3 m) in contrast to traffic accident in young patients. Severely injured patients in the older age group showed a significantly higher overall mortality rate compared to the younger group (37.6% vs. 11.7%; <i>p</i> = 0.000). In both groups, the 30-day survival for patients without head injuries was significantly better compared to patients with head injuries (92.7% vs. 85.3%; <i>p</i> = 0.017), especially analyzing elderly patients (86.6% vs. 58.6%; <i>p</i> = 0.003). The relative risk of 30-day mortality in patients who suffered a head injury was also higher in the elderly group (OR: Group 1: 4.905; Group 2: 7.132). Conclusion: In contrast to younger patients, falls from low heights (<3 m) are significant risk factors for severe injuries in the geriatric collective. Additionally, elderly patients with an ISS ≥ 16 had a significantly higher mortality rate compared to severe injured younger patients. Head injuries, even minor head traumata, are associated with a significant increase in mortality. These findings will contribute to the development of more age-related therapy strategies in severely injured patients.https://www.mdpi.com/2077-0383/10/2/185severe injuryelderly patientshead injurymortality |
| spellingShingle | Daniel Popp Borys Frankewycz Siegmund Lang Antonio Ernstberger Volker Alt Michael Worlicek Maximilian Kerschbaum Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? Journal of Clinical Medicine severe injury elderly patients head injury mortality |
| title | Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? |
| title_full | Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? |
| title_fullStr | Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? |
| title_full_unstemmed | Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? |
| title_short | Are There Any Red Flag Injuries in Severely Injured Patients in Older Age? |
| title_sort | are there any red flag injuries in severely injured patients in older age |
| topic | severe injury elderly patients head injury mortality |
| url | https://www.mdpi.com/2077-0383/10/2/185 |
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