‘Silver’ trauma: predicting mortality in elderly major trauma based on place of injury

Hendrickson, Susan A.; Osei-Kuffour, Denise; Aylwin, Christopher; Fertleman, Michael; Hettiaratchy, Shehan

doi:10.1186/1757-7241-23-s2-a4

Cited by 2 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Older trauma represents 20% of all major trauma in the UK [ 4 ] and projections suggest that by 2040 one in four people will be aged 65 or over [ 3 ]. With the greatest proportion attended aged between the ages of 65–74 years, older trauma represents a significant proportion (20%) of all trauma attended by HEMS, consistent with the current literature [ 1 , 2 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Low impact trauma and specifically low energy falls result in 30% of serious injury in patients > 65 years, compared to 4% in < 65 years; and are 10 times more likely to cause death [ 15 , 18 ]. Only 33–50% of older trauma patients protect themselves with outstretched arms, compared to 90% of younger adults [ 4 ]. This exposes patients to head, neck and thoracic injuries with a high injury severity that is disproportionate to mechanism [ 14 ], with associated worse functional outcomes regardless of injury severity [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Inevitably, growing demand is being placed on acute healthcare services. The outcome of older trauma patients is difficult to predict; however, published studies indicate an increased risk of morbidity and mortality, with a mortality rate of 50% in adults aged over 75 years [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Griggs

Barrett²,

Avest

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background Helicopter Emergency Medical Services (HEMS) respond to serious trauma and medical emergencies. Geographical disparity and the regionalisation of trauma systems can complicate accurate HEMS dispatch. We sought to evaluate HEMS dispatch sensitivity in older trauma patients by analysing critical care interventions and conveyance in a well-established trauma system. Methods All trauma patients aged ≥65 years that were attended by the Air Ambulance Kent Surrey Sussex over a 6-year period from 1 July 2013 to 30 June 2019 were included. Patient characteristics, critical care interventions and hospital disposition were stratified by dispatch type (immediate, interrogate and crew request). Results 1321 trauma patients aged ≥65 were included. Median age was 75 years [IQR 69–89]. HEMS dispatch was by immediate (32.0%), interrogation (43.5%) and at the request of ambulance clinicians (24.5%). Older age was associated with a longer dispatch interval and was significantly longer in the crew request category (37 min [34–39]) compared to immediate dispatch (6 min [5–6] (p = .001). Dispatch by crew request was common in patients with falls < 2 m, whereas pedestrian road traffic collisions and falls > 2 m more often resulted in immediate dispatch (p = .001). Immediate dispatch to isolated head injured patients often resulted in pre-hospital emergency anaesthesia (PHEA) (39%). However, over a third of head injured patients attended after dispatch by crew request received PHEA (36%) and a large proportion were triaged to major trauma centres (69%). Conclusions Many patients who do not fulfil the criteria for immediate HEMS dispatch need advanced clinical interventions and subsequent tertiary level care at a major trauma centre. Further studies should evaluate if HEMS activation criteria, nuanced by age-dependant triggers for mechanism and physiological parameters, optimise dispatch sensitivity and HEMS utilisation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Griggs

Barrett²,

Avest

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…According to the information obtained from 319 trauma patients over 65-years, the most common cause of trauma in people over 65 years of age is fall on the same level (48.9% of all cases). The results of other studies show that in most medical centers, falls are the main cause of trauma in elderly people, according to the frequency of the causes of trauma, it is appropriate to take consideration to reduce this occurrence in each area (11,12). Paying attention to the underlying diseases, drugs and neurological disorders related to aging in these patients can prevent the occurrence of trauma in this age group to some extent (13).…”

Section: Discussionmentioning

confidence: 99%

“…The assessment and management of geriatric trauma in the ED require a multidisciplinary approach involving emergency physicians, nurses, surgeons, social workers, and rehabilitation specialists (11). The initial evaluation should focus on identifying life-threatening injuries while considering potential agerelated complications such as delayed healing or impaired immune response (12). Diagnostic imaging plays a crucial role in evaluating geriatric trauma patients (13,14).…”

Section: Introductionmentioning

confidence: 99%

The etiology of trauma in geriatric traumatic patients refer to an academic trauma center: a cross sectional study

Pishbin,

Zakeri,

Kakhki

et al. 2024

Preprint

View full text Add to dashboard Cite

Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years and older. The management of geriatric trauma in the Emergency Department requires a comprehensive approach that takes into account the physiological changes associated with aging, as well as the increased vulnerability and complexity of injuries in this population. This is a cross-sectional study aimed at evaluating the etiology of trauma in geriatric patients referred to the ED of level-1 an academic center. All patients with complaints of trauma are evaluated, patients over 65-years enrolled in the study. 319 patients were investigated, 49/8% male and 50/2%female.The most common underlying diseases are high blood pressure, diabetes type 2 and ischemic heart diseases. The most common trauma cause was falling from a same level (48/9%), followed by a fall from a height (16/6%), accident with cars (16%) and motorcycles (9/1%). The most common injury was extremities trauma (71/5%) following head trauma (13/2%) and chest trauma (6%). The severity of injury in extremity was more in women, and chest trauma was more sever in men. According to our results, the fall and subsequent car accident had the highest frequency as a cause of trauma in elderly patients admitted to our academic trauma center. Hypertension and diabetes have also been the most common underlying diseases. Head and neck injuries are life-threatening and critical in a larger number of patients than other injuries, and protecting them can be effective in reducing mortality and serious injuries in elderly trauma patients.

show abstract

‘Silver’ trauma: predicting mortality in elderly major trauma based on place of injury

Cited by 2 publications

References 1 publication

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

The etiology of trauma in geriatric traumatic patients refer to an academic trauma center: a cross sectional study

Contact Info

Product

Resources

About