The impact of advanced age on trauma triage decisions and outcomes: A statewide analysis

Lehmann, R; Beekley, Alec C.; Casey, Linda; Salim, Ali; Martin, Matthew J.

doi:10.1016/j.amjsurg.2008.12.037

Cited by 165 publications

(146 citation statements)

References 18 publications

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“…[28][29][30][31][32][33][34][35][36] We found that odds of death are higher for patients treated at Level I and II trauma centers. While this may seem inconsistent with established lifesaving ability of trauma center care, 4 this is likely a reflection of trauma system organization and triage decisions, with the most critically injured patients receiving treatment at Level I and II centers.…”

Section: Discussionmentioning

confidence: 97%

Rural risk: Geographic disparities in trauma mortality

Jarman

Castillo

Carlini

et al. 2016

Surgery

116

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Section: Discussionmentioning

confidence: 97%

Rural risk: Geographic disparities in trauma mortality

Jarman

Castillo

Carlini

et al. 2016

Surgery

116

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“…8 Lehmann et al found that elderly patients were less likely to undergo rapid trauma evaluation and therefore less likely to have occult injuries identified in a timely fashion. 9 Elderly patients typically have more medical comorbidities. The presence of preexisting medical conditions independently increases mortality in patients with trauma 10 as well as length of stay (LOS).…”

Section: Introductionmentioning

confidence: 99%

Orthopedic Trauma and Aging

Peterson

Jiwanlal

Rocca

et al. 2015

Geriatr Orthop Surg Rehabil

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The elderly (age 70þ) patient with orthopedic trauma is a rapidly growing subset of patients in the United States. Due to increased medical comorbidities and decreased physiological reserve, morbidity and mortality after trauma may significantly differ from those patients younger than 70 years old. A retrospective review was performed to investigate the effect of age on orthopedic trauma. A total of 870 records of patients with orthopedic trauma from 2006 to 2009 at our Level One trauma center were reviewed. A database was created to include demographics, type and number of comorbid conditions at presentation, injuries, intensive care unit (ICU) and hospital length of stay, and description of the fracture. Patients aged 70 years and older had an increased number of comorbidities per person (3.3214-P < .0001). Length of stay in patients aged 70 years and older was not significantly greater than that of the younger patients. They spent an average of 14.76 days in the hospital compared to 13.42 days for the combined younger patients (P ¼ .45), but they spent significantly (P < .0001) more of their stay in the ICU (52.74% vs 34.9% for the younger cohorts). The number of fractures per patient was lower (1.66) in the 70 and older age-group when compared to younger populations (P < .0001). The 70 and older group was more likely to have their injury due to a fall and less likely to have solid organ injuries. As the number of elderly patients increase, continued research in the management of elderly patients with trauma can lead to protocols and practice guidelines to improve outcomes.

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“…Nowadays, more precise markers of tissue hypoperfusion, such as baseline consumption (arterial blood gas analysis) and arterial blood lactate, should be employed when evaluating the elderly 4 . It is believed that the elderly are more prone to suffer more serious injuries in equivalent accidents and are at greater risk of death from injuries of similar severity 1,6 . In our study, we observed that orthopedic injuries and injuries to the extremities are more common among elderly trauma victims.…”

Section: Discussionmentioning

confidence: 99%

“…These factors mean that mortality is higher than in other age groups, even when comparisons are made with control for severity according to trauma indexes 1,5,6 . Nevertheless, we find that the majority of elderly accident victims have suffered from milder trauma mechanisms, such as falls from their own height.…”

mentioning

confidence: 99%

“…Nevertheless, we find that the majority of elderly accident victims have suffered from milder trauma mechanisms, such as falls from their own height. This can lead to assessment errors, delaying diagnosis and treatment in exactly that group of patients for which small errors can create large problems 6 . Trauma centers should consider using specific protocols for monitoring and treating traumatized elderly people 7 .…”

mentioning

confidence: 99%

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