Survivorship After High-Energy Geriatric Trauma

Gitajn, Ida Leah; Castillo, Renan C.; Breazeale, Stephen; Schoonover, Carrie; Berger, Peter B.; Huang, Yanjie; O’Hara, Nathan N.; O’Toole, Robert V.; Sciadini, Marcus F.

doi:10.1097/bot.0000000000000864

Cited by 14 publications

(14 citation statements)

References 26 publications

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“…As for the main underlying causes of death, a previous study supports our findings that high-energy trauma is more prevalent among the elderly between the ages of 60 and 69 years and that low-energy fractures are more prevalent in the elderly aged ≥80 years [16]. Therefore, younger elderly people perform activities that put them at greater risk of high-energy accidents, which may be associated with greater complications due to the high impact presented by the mechanism of injury.…”

Section: Discussionsupporting

confidence: 87%

“…Closed fractures were determined to be those without any skin rupture, while fractures with bone exposure were established as open fractures. Regarding the mechanism of injury, the elderly patients were classified into two groups as follows: (i) low-energy trauma, corresponding to GLF, falls from chairs or beds, and (ii) high-energy trauma, equivalent to falling from considerable heights; motor vehicle collisions; or collisions with motorcyclists, cyclists, and pedestrians [16].…”

Section: Independent Variablesmentioning

confidence: 99%

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Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

et al. 2020

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Objective: This study analyzes the causes of death, survival, and other related factors in hospitalized elderly people with fractures over the course of one year. Methods: We followed 376 fracture patients for one year in a prospective cohort study to a reference hospital in central Brazil. The Cox regression model was used to analyze factors associated with survival. Results: The results indicate that the one-year mortality rate was high (22.9%). The independent factors linked to lower overall survival were as follows: patients aged ≥80 years with previous intensive care unit (ICU) admission and presence of comorbidities (diabetes mellitus [DM] and dementia). Conclusion: Our study results may contribute to a better understanding of the impact of fractures on the elderly population and reinforce the need to oversee age-groups, diabetic patients, and patients with complications during hospitalization.

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Section: Discussionsupporting

confidence: 87%

Section: Independent Variablesmentioning

confidence: 99%

Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

et al. 2020

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“…The main strength of this study is the strict matching criteria which are all proven and validated predictors of outcome in trauma [20,[32][33][34][35]. With this study concept, we were able to study the effect of age on the outcome of severely injured patients.…”

Section: Strengths/limitationsmentioning

confidence: 99%

Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis

Jensen

Lempert

Sprengel

et al. 2020

JCM

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Geriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be among the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding mortality, length-of-stay and complications with a matched pair analysis. We included patients older than 17 years with an Injury Severity Score (ISS) of 16 or more admitted to our level 1 trauma center between January 2008 and December 2015. The cohort was stratified into two groups (age < 70 and ≥ 70 years). One-to-one matching was performed based on gender, ISS, mechanism of injury (penetrating/blunt), Glasgow coma scale (GCS), base excess, and the presence of coagulopathy (international normalized ratio (INR) ≥ 1.4). Outcome was compared using the paired t-test and McNemar-test. A total of 1457 patients were identified. There were 1022 male (70%) and 435 female patients. Three hundred and sixty-four patients (24%) were older than 70 years. Matching resulted in 57 pairs. Mortality as well as length-of-stay were comparable between geriatric and non-geriatric polytraumatized patients. Complication rate (34% vs. 56%, p = 0.031) was significantly higher in geriatric patients. This indicates the possibility of similar outcomes in geriatric polytraumatized patients receiving optimal care.

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“…The main strength of this study are the strict matching criteria which all are proven and validated predictors of outcome in trauma (20,(30)(31)(32)(33).…”

Section: Strengths/limitationsmentioning

confidence: 99%

“…Furthermore, some of the matching criteria require critical discussion. Even though GCS, coagulopathy, BE and ISS are considered to be strong predictors for adverse outcome in trauma (29), elderly patients are presenting with more comorbidities, hence there might be a bias within the matching itself due to pre-existing conditions (20,(30)(31)(32)(33). It is more likely to nd a pre-existing decreased GCS in an older patient.…”

Section: Mortalitymentioning

confidence: 99%

Is there any difference in the outcome of geriatric and non-geriatric severely injured patients? – A seven-year, retrospective, observational cohort study with matched-pair analysis

Jensen¹,

Lempert²,

Sprengel³

et al. 2020

Preprint

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Background: The aging population has a tremendous impact on health care. Geriatric trauma is expected to increase due to the lifestyle and activity of the aging population and will be one of the major future challenges in health care. Therefore, the aim of this study was to investigate differences between polytraumatized geriatric and non-geriatric patients regarding 1) mortality, 2) length of stay, and 3) complications with a matched pair analysis. Methods: We included patients older than 17 years with an Injury Severity Score (ISS) of 16 or more admitted to our level 1 trauma center between January 2008 and December 2015. The cohort was stratified into two groups (age < 70 years “non-geriatric”, age ≥ 70 years “geriatric”). One-to-one matching was performed based on gender, ISS, mechanism of injury (penetrating/blunt), Glasgow Coma Scale (GCS), base excess, and the presence of coagulopathy (INR ≥ 1.4). Outcome was compared using the paired t-test and McNemar-test. Results: A total of 1457 patients with a mean age of 62 (± 21) years were identified. There were 1022 male (72%) and 435 female patients. Three hundred forty six patients (24%) were older than 70 years. Matching resulted in 57 pairs. 1) Mortality (25% vs 32% respectively; p = 0.219) as well as 2) length of stay (12.5 (± 13.3) days vs 11.8 (± 11.8) days respectively, p = 0.754) were comparable between geriatric and non-geriatric polytraumatized patients. 3) The complication rate (34% vs. 56%, p = 0.031) was significantly higher in geriatric patients. Conclusion: Despite significantly higher complication rates amongst the geriatric trauma patients, there were no significant differences regarding mortality and length of stay in this matched pair analysis – indicating the possibility of similar outcome in geriatric polytraumatized patients receiving optimal care.

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Survivorship After High-Energy Geriatric Trauma

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 14 publications

References 26 publications

Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

Survival Analysis of Hospitalized Elderly People with Fractures in Brazil Over One Year

Is There Any Difference in the Outcome of Geriatric and Non-Geriatric Severely Injured Patients?—A Seven-Year, Retrospective, Observational Cohort Study with Matched-Pair Analysis

Is there any difference in the outcome of geriatric and non-geriatric severely injured patients? – A seven-year, retrospective, observational cohort study with matched-pair analysis

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