Trauma Mortality Factors in the Elderly Population
Trauma in the elderly population is frequent and is associated with significant mortality, owing not only to age-related factors, but also those complicated factors relating to lack of physical reserves, the injury severity, preexisting comorbidity, and insufficient ability for systemic compensation...
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| Format: | Article |
| Language: | English |
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Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)
2008-03-01
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| Series: | International Journal of Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1873959808700036 |
| _version_ | 1818016339902595072 |
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| author | Wen-Han Chang Shin-Han Tsai Yu-Jang Su Chien-Hsuan Huang Kou-Song Chang Cheng-Ho Tsai |
| author_facet | Wen-Han Chang Shin-Han Tsai Yu-Jang Su Chien-Hsuan Huang Kou-Song Chang Cheng-Ho Tsai |
| author_sort | Wen-Han Chang |
| collection | DOAJ |
| description | Trauma in the elderly population is frequent and is associated with significant mortality, owing not only to age-related factors, but also those complicated factors relating to lack of physical reserves, the injury severity, preexisting comorbidity, and insufficient ability for systemic compensation. Age-related mortality remains constant in the low to moderately severe injury categories compared with the severely injured groups (injury severity score, ISS, 25 or greater). The age-related insufficient physical reserves for cardiac output leave this group in the state of hypoperfusion, which is hard to identify. The circumstances around metabolic demands and lower maximum heart rate with a higher peripheral vascular resistance make the cardiovascular system reserve unable to respond, which means that a diagnosis of shock is more difficult to establish. Higher ISSs obtained at injury in the elderly population can predict higher mortality better than in younger population, but they have not been as effective in predicting mortality obtained at follow-up of elderly trauma patients compared with those at the time at injury. More aggressive care for the elderly trauma patient has been shown to decrease mortality. Because of the multiple mortality factors, a decision on treatment type following trauma in geriatric patients is unable to be made if the clinician is not alert to the pitfalls which can affect these individuals. Regardless of age or injury severity and with special considerations for those patients who arrive in a moribund condition, geriatric trauma patients should be treated with as much effort as their younger counterparts, that is, aggressively and within a certain time frame. [International Journal of Gerontology 2008; 2(1): 11–17] |
| first_indexed | 2024-04-14T07:11:59Z |
| format | Article |
| id | doaj.art-ebcb82f59d534941bec7e6f2591b8e35 |
| institution | Directory Open Access Journal |
| issn | 1873-9598 |
| language | English |
| last_indexed | 2024-04-14T07:11:59Z |
| publishDate | 2008-03-01 |
| publisher | Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) |
| record_format | Article |
| series | International Journal of Gerontology |
| spelling | doaj.art-ebcb82f59d534941bec7e6f2591b8e352022-12-22T02:06:25ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982008-03-0121111710.1016/S1873-9598(08)70003-6Trauma Mortality Factors in the Elderly PopulationWen-Han Chang0Shin-Han Tsai1Yu-Jang Su2Chien-Hsuan Huang3Kou-Song Chang4Cheng-Ho Tsai5Emergency Department, Mackay Memorial Hospital, Taipei, TaiwanGraduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, TaiwanEmergency Department, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Rehabilitation, Tai-En Memorial Hospital, Taipei, TaiwanEmergency Department, Mackay Memorial Hospital, Taipei, TaiwanSection of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanTrauma in the elderly population is frequent and is associated with significant mortality, owing not only to age-related factors, but also those complicated factors relating to lack of physical reserves, the injury severity, preexisting comorbidity, and insufficient ability for systemic compensation. Age-related mortality remains constant in the low to moderately severe injury categories compared with the severely injured groups (injury severity score, ISS, 25 or greater). The age-related insufficient physical reserves for cardiac output leave this group in the state of hypoperfusion, which is hard to identify. The circumstances around metabolic demands and lower maximum heart rate with a higher peripheral vascular resistance make the cardiovascular system reserve unable to respond, which means that a diagnosis of shock is more difficult to establish. Higher ISSs obtained at injury in the elderly population can predict higher mortality better than in younger population, but they have not been as effective in predicting mortality obtained at follow-up of elderly trauma patients compared with those at the time at injury. More aggressive care for the elderly trauma patient has been shown to decrease mortality. Because of the multiple mortality factors, a decision on treatment type following trauma in geriatric patients is unable to be made if the clinician is not alert to the pitfalls which can affect these individuals. Regardless of age or injury severity and with special considerations for those patients who arrive in a moribund condition, geriatric trauma patients should be treated with as much effort as their younger counterparts, that is, aggressively and within a certain time frame. [International Journal of Gerontology 2008; 2(1): 11–17]http://www.sciencedirect.com/science/article/pii/S1873959808700036elderly traumageriatric considerationmortalitypitfall |
| spellingShingle | Wen-Han Chang Shin-Han Tsai Yu-Jang Su Chien-Hsuan Huang Kou-Song Chang Cheng-Ho Tsai Trauma Mortality Factors in the Elderly Population International Journal of Gerontology elderly trauma geriatric consideration mortality pitfall |
| title | Trauma Mortality Factors in the Elderly Population |
| title_full | Trauma Mortality Factors in the Elderly Population |
| title_fullStr | Trauma Mortality Factors in the Elderly Population |
| title_full_unstemmed | Trauma Mortality Factors in the Elderly Population |
| title_short | Trauma Mortality Factors in the Elderly Population |
| title_sort | trauma mortality factors in the elderly population |
| topic | elderly trauma geriatric consideration mortality pitfall |
| url | http://www.sciencedirect.com/science/article/pii/S1873959808700036 |
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