Abstract
This retrospective study aimed to compare the clinical characteristics and trauma scores of Intensive Care Unit (ICU) trauma patients 65 years and older with the patients under 65 years old. Trauma patients (n=161) who stayed at least 24 hours in ICU were included. Patients younger than 65 years were included into Group 1 (n=109) and patients aged ≥65 years (n=52) were included into Group 2. Patient characteristics and trauma index scores (GCS; APACHE II score, ISS; TRISS and RTS) at ICU admission were calculated. The patients in Group 2 had more comorbid disease compared with Group 1 (61.5%, 6.4%) (p=0.001). The Trauma-related Injury Severity Score score were higher in Group 1 (49.76±33.75) compared with Group 2 (35.38±34.93) (p=0.006). The APACHE II score were higher in Group 2 (20.08±7.60) compared with Group 1 (17.00±6.90) (p=0.007). The need for invasive mechanical ventilation and tracheostomy were more frequent in Group 2 trauma patients compared with those of patients in Group 1 (92.3%, 73.4%; p=0.003; 26.9%, 8.3%; p=0.002; respectively). The need for transfusion of packed red blood cell suspension (PRBC) was more frequent in Group 2 compared with Group 1 (92.3%, 55.0%; respectively) (p=0.001). The mortality rate was found to be higher in Group 2 compared with Group 1 (48.1%, 19.3%; respectively) (p=0.001). The elderly trauma patients have more comorbid disease, higher scores for APACHE II and lower scores for TRISS, more mechanical ventilation and tracheostomy requirements and higher mortality rate compared with young trauma patients.
Highlights
Trauma is an important cause of death in all ages and requires a rapid and systematic approach to minimize mortality [1]
The need for invasive mechanical ventilation and tracheostomy were more frequent in Group 2 trauma patients compared with those of patients in Group 1 (92.3%, 73.4%; p=0.003; 26.9%, 8.3%; p=0.002; respectively)
The need for transfusion of packed red blood cell suspension (PRBC) was more frequent in Group 2 compared with Group 1 (92.3%, 55.0%; respectively) (p=0.001)
Summary
Trauma is an important cause of death in all ages and requires a rapid and systematic approach to minimize mortality [1]. Most commonly used scoring systems in clinics are Glasgow coma score (GCS); Acute Physiology and Chronic Health Evaluation (APACHE) II score, Injury Severity Score (ISS); the Trauma-related Injury Severity Score (TRISS) and the Revised Trauma Score (RTS). The RTS is a physiological scoring system and it assesses the severity of traumatic injuries based on respiratory rate, systolic arterial pressure, and GCS [4]. The APACHE II score estimates the patient’s mortality risk at the Intensive Care Unit (ICU) admission based on a number of laboratory values, age, and underlying health conditions [5]. The TRISS provides a simultaneous assessment of anatomic injury and a patient’s physiological condition and it is calculated from the ISS and RTS via a formulae [7]. Many studies investigating the effectiveness of scoring systems are available in the literature [8,9,10,11,12,13,14]
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