Abstract
Increased life expectancy exposes a great number of elderly people to serious accidents, thus increasing the amount of major geriatric trauma cases. The aim of our study was to determine the profile of elderly patients undergoing major trauma, and the contributing factors predicting mortality in this specific patient group, compared to the younger population. Retrospective analysis of 1051 patients with major trauma admitted over ten years in a Level-1 trauma center was performed. Data collected were: history, nature and type of trauma; age and sex; vital signs on admission; injury severity score; shock index; comorbidities; coagulation diathesis; injury patterns; emergency measures taken; main diagnosis; mortality; and length of hospital and intensive care unit (ICU) stay. Geriatric patients admitted for major trauma have a mortality rate almost four times greater (47%) than their younger counterparts (14%) with the same ISS. According to statistical regression analysis, anti-platelet therapy (OR 3.21), NACA (National Advisory Committee for Aeronautics) score (OR 2.23), GCS (OR 0.83), ISS (OR 1.07) and age (OR 1.06) are the main factors predicting mortality. Conclusion: Geriatric major trauma patients admitted to our trauma resuscitation area have a high mortality rate. Age, GCS, ISS and NACA scores as well as anti-platelet therapy are the main factors predicting mortality.
Highlights
Western nations including Switzerland are confronting a definite aging of their populations
The aim of our study was to describe the epidemiology of major trauma in our elderly population, describe their characteristics and determine the factors contributing to their mortality, compared to the younger population
Study Design and Data Description. This is a retrospective, monocentric observational study carried out in the emergency department (ED) of the Lausanne University Hospital (CHUV), in Western Switzerland, between 2005 and 2015. It is based on the ED patient registry, including details of treatment given in the field by prehospital emergency physicians and paramedics prior to admission to the trauma resuscitation area
Summary
Western nations including Switzerland are confronting a definite aging of their populations. In Switzerland, severe injury is the fourth cause of death between 65 and years, and the fifth above years, with an all-over mortality rate of 25/100,000/year [3]. In this group, falls and road crashes account for most accidents, while among adults under 65 years, road crashes, sports and urban violence take precedence [2,4]. Recent evidence indicates a shift from this trimodal distribution to a bimodal distribution, with a drop in late deaths over time, in Western countries that have implemented trauma management systems for major injuries [6]. Organized trauma networks allow for efficient reduction of mortality in this patient group [9,10,11,12]
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