Trauma in the Very Elderly: A Community-Based Study of Outcomes at Trauma and Nontrauma Centers

Meldon, Stephen W.; Reilly, Mary; Drew, Barbara L.; Mancuso, Charlene; Fallon, William F.

doi:10.1097/00005373-200201000-00014

Cited by 97 publications

(80 citation statements)

References 37 publications

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“…A variety of factors affect outcome from major trauma in older people. These include demographic factors, such as age, gender and social status; injury characteristics (injury pattern and severity); pre-existing medical conditions and the patients' physiological state on admission to hospital (8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Despite extensive research, there is no clear agreement on the relative impact of these diverse factors on mortality in older people with major trauma.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Sammy

Lecky

Sutton

et al. 2016

Injury

104

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Section: Introductionmentioning

confidence: 99%

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Sammy

Lecky

Sutton

et al. 2016

Injury

104

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“…In tropical countries, where the aging process occurs earlier, the age of 60 is considered the threshold for the onset of old age 3 . With the active participation of older people in society, the term "super elderly", or "very elderly", has appeared in the literature, represented by individuals with over 80 years 4,5 . It is believed that this subgroup of patients presents a greater impairment of functional organic reserve even before suffering a trauma, which warrants special attention both from diagnosis and therapeutic standpoints 1,5,6 .…”

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confidence: 99%

“…With the active participation of older people in society, the term "super elderly", or "very elderly", has appeared in the literature, represented by individuals with over 80 years 4,5 . It is believed that this subgroup of patients presents a greater impairment of functional organic reserve even before suffering a trauma, which warrants special attention both from diagnosis and therapeutic standpoints 1,5,6 . There are not many studies that address the specific characteristics of traumatized "very old", neither comparing the lesions found in elderly patients over and under 80 years 4 .…”

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confidence: 99%

“…The elderly aged over 80 years have been recognized as a subgroup called "super elderly" due to the specific clinical conditions related to this age group 4,5 . The aim of this study was precisely to investigate whether this subgroup of traumatized had some special feature, such as mechanism of injury, injury found and severity, that would differentiate them from the elderly under the age of 80 years.…”

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confidence: 99%

“…The variables most often related to higher mortality in elderly trauma victims are the presence of systolic blood pressure less than 150 mmHg at admission, metabolic acidosis, the presence of multiple fractures and head trauma 25 . A controversial aspect in the analysis of Table 2 -Table 2 -Table 2 -Table 2 -Table 2 Table 3 Table 3 Table 3 Table 3 Table 3 1,4,5,15,26 . The Trauma Score (TS) and the severity of injury (ISS) are not specific to the elderly population and are considered to have low predictive value for mortality 25,26 .…”

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confidence: 99%

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Análise comparativa das características do trauma entre idosos com idade superior e inferior a 80 anos

Parreira

Farrath

Soldá

et al. 2013

Rev. Col. Bras. Cir.

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OBJETIVO: comparar as características do trauma entre idosos e "superidosos". MÉTODOS: análise retrospectiva dos protocolos de vítimas de trauma fechado com idade igual ou superior a 70 anos. Os idosos de idade entre 70 e 79 anos foram incluídos no grupo I, os de idade igual ou maior de 80 anos no grupo II. Análise estatística foi realizada através dos testes t de Student, qui-quadrado e Fisher, considerando p<0,05 significativo. RESULTADOS: Foram incluídos no estudo 281 doentes (grupo I-149; grupo II-132). A idade variou de 70 a 99 anos (79,1 ± 6,7 anos), sendo 52,3% do sexo masculino. Os superidosos se caracterizaram por apresentar menor média de AIS em abdome (0,10 ± 0,59 vs. 0,00 ± 0,00; p=0,029), menor frequência de vítimas do sexo masculino (59,1% vs. 44,3%; p=0,013), maior frequência de queda da própria altura (44,3% vs. 65,2%; p=0,028) e menor frequência de fraturas de membros superiores (9,4% vs. 2,3%; p=0,010). Não observamos diferença significativa na comparação das demais variáveis entre os grupos. CONCLUSÃO: O trauma em idosos é um grave problema de saúde pública, com tendência à piora progressiva pelo envelhecimento da população. Os dados deste estudo nos auxiliam com uma visão mais clara do trauma nos superidosos, um subgrupo que merece atenção especial.

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Factors Associated With Trauma Center Use for Elderly Patients With Trauma

Hsia¹

2011

Arch Surg

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Objectives To estimate the likelihood of trauma center admission for injured elderly patients with trauma, determine trends in trauma center admissions, and identify factors associated with trauma center use for elderly patients with trauma. Design Retrospective analysis. Setting Acute care hospitals in California. Patients All patients hospitalized for acute traumatic injuries during the period from January 1, 1999, to December 31, 2008 (n=430 081). Patients who had scheduled admissions for nonacute or minor trauma were excluded. Main Outcome Measure Likelihood of admission to level I or II trauma center was calculated according to age categories after adjusting for patient and system factors. Results Of 430 081 patients admitted to California acute care hospitals for trauma-related diagnoses, 27% were older than 65 years. After adjusting for demographic, clinical, and system factors, compared with trauma patients aged 18–25 years, the odds of admission to a trauma center decreased with increasing age; patients aged 26–45 years had lower odds (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.71–0.80) of being admitted to a trauma center for their injuries than did patients 46–65 years of age (OR, 0.57; 95% CI, 0.54–0.60), patients 66–85 years of age (OR, 0.35; 95% CI, 0.30–0.41), and patients older than 85 years (OR, 0.30; 95% CI, 0.25–0.36). Similar patterns were found when stratifying the analysis by trauma type and severity. Living more than 50 miles away from a trauma center (OR, 0.03; 95% CI, 0.01–0.06) and lack of county trauma center (OR, 0.17; 95% CI, 0.09–0.35) were also predictors of not receiving trauma care. Conclusion Age and likelihood of admission to a trauma center for injured patients were observed to be inversely proportional after controlling for other factors. System-level factors play a major role in determining which injured patients receive trauma care.

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Trauma in the Very Elderly: A Community-Based Study of Outcomes at Trauma and Nontrauma Centers

Abstract: Risk-adjusted outcomes, in this population, differed between TC and AC settings. Head injury, injury severity, and lack of TC verification are associated with hospital mortality in very elderly trauma patients.

Cited by 97 publications

References 37 publications

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Factors affecting mortality in older trauma patients—A systematic review and meta-analysis

Análise comparativa das características do trauma entre idosos com idade superior e inferior a 80 anos

Factors Associated With Trauma Center Use for Elderly Patients With Trauma

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