Major trauma in elderly – predictors of survival

• Main Authors: Drago Brilej, Božidar Buhanec, Radko Komadina, Miodrag Vlaović
• Format: Article
• Language: English
• Published: Slovenian Medical Association 2007-12-01
• Series: Zdravniški Vestnik
• Subjects: polytrauma; elderly; prognostic factors
• Online Access: http://vestnik.szd.si/index.php/ZdravVest/article/view/1973
• ISSN: 1318-0347; 1581-0224

<p><strong>Background:</strong> Injury will soon become a disease more closely associated with elderly and not just a problem that affects young members of our society. Data about the outcome of polytraumatized elderly patients might have consequences on therapeutic strategies and health care planning.</p><p><strong>Material and methods:</strong> A total of 41 patients met the inclusion criteria: age &gt; 65 years, blunt trauma, major injury to at least two bodily regions, Injury Severity Score (ISS) at least 18. Mortality, factors that predict mortality and functional ability 1 year after injury were reviewed. The standardized form was used for the purpose of collecting of data. The following data were obtained: age, sex, mechanism of injury, pre-existing medical conditions, injury type and severity and complications.</p><p><strong>Results:</strong> In-hospital mortality was 39 %. Female patients were more likely to die following trauma as male patients. Severe thoracic injury was found to correlate with mortality. The mean ISS was 31.3 (SD 11.3). The mortality correlates closely with ISS. The TRISS methodology yielded the W statistic = –0.15 and Z which was not significant. The normal admitting physiologic status of the patient could be misleading. Complications following trauma occurred in 78 % of our patients. 85.7 % patients had 10 or more points out of 12 on the FIM index one year after injury.</p><p><strong>Conclusions:</strong> The death rate in hospitalized geriatric trauma victims was high. The sum of injuries was the best outcome predictor in the study group. Physiologic parameters of injury severity were insufficient in predicting survival for these elderly patients. Further studies are needed to adjust the treatment algorithms in elderly patients. Data could be obtained through national trauma registry.</p>