A Comprehensive Multidisciplinary Approach—The Ideal Future State of Geriatric Trauma Care

Abstract

Including fall prevention for older adults in your trauma injury prevention program-introducing Farewell to Falls.

Intensive care unit readmission in injured older adults: Modifiable risk factors and implications

“…These findings also underline the importance of viewing any episode of delirium as a marker of ongoing or potential complications, which, when documented, should, in turn, prompt anticipatory care planning conversations with the patient and their family. Our findings of increased mortality, along with previous studies demonstrating delayed recovery, functional and long-term cognitive decline, and increased risk of institutionalization after delirium, reinforce the necessity of a multidisciplinary approach to geriatric trauma care with an emphasis on delirium prevention and management 21 . Pharmacists have been present on team rounds for the past two decades, and geriatric trauma bundles have been implemented at our institution since 2013, which include standard order sets with algorithms for pain, sleep, and nutritional management, and were expanded to include protocolized consults to geriatric medicine for optimization of polypharmacy and comorbidities in 2017 22 .…”

“…Our findings of increased mortality, along with previous studies demonstrating delayed recovery, functional and long-term cognitive decline, and increased risk of institutionalization after delirium, reinforce the necessity of a multidisciplinary approach to geriatric trauma care with an emphasis on delirium prevention and management. 21 Pharmacists have been present on team rounds for the past two decades, and geriatric trauma bundles have been implemented at our institution since 2013, which include standard order sets with algorithms for pain, sleep, and nutritional management, and were expanded to include protocolized consults to geriatric medicine for optimization of polypharmacy and comorbidities in 2017. 22 These types of bundled order sets have been shown to reduce the risk of delirium in this population, but further analysis is warranted to evaluate the overall impact of these geriatric trauma protocols.…”

“…With respect to injury characteristics, readmitted geriatric patients had a higher median ISS (21 [IQR, [14][15][16][17][18][19][20][21][22][23][24][25][26] vs. 16 [IQR, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]) ( p < 0.001) (Table 1). Mechanism of injury did not differ.…”