Characteristics and Outcomes of Eldery Trauma in Samsun: A Retrospective Study
DOI:
https://doi.org/10.17986/blm.1640Keywords:
Elderly, Mortality, Comorbidity, GeriatryAbstract
Objective: Traumas belonging to the population aged 65 and over continue to be a prominent health problem in the 21st century. In this study, we aimed to understand and illuminate the geriatric trauma cases admitted to the regional hospital in Samsun.
Methods: The files and records on the hospital automation system of the cases aged 65 and over who came to the Emergency Department of Ondokuz Mayıs University Faculty of Medicine between 01.01.2011 and 31.12.2020 as a result of a traumatic event were retrospectively examined. The cases in our study were evaluated in terms of demographic characteristics, events that occurred, injured body area, hospitalization and length of stay, existing comorbidities, mortality.
Results: Of the total 1960 cases, 65.8% of the cases were male and 34.2% were female. At the date of the event, 62.8% of the cases were in the 65-74 age range. The most common (36.1%) type of event was falling. It is found that the most (36.7%) frequently injured body area is the head and neck region, and the least (5.9%) is the pelvis. 68.7% of the cases were hospitalized and 135 cases died.
Conclusion: The elderly population, which has begun to take a greater role in both social and business life; increased risk with trauma. Advancing age and existing comorbidities lead to a more serious outcome of trauma in the elderly compared to the young. Physicians should be cautious about performing a detailed examination, especially in terms of inadequacy in the records and suspicion of abuse/negligence.
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References
Fried LP. Epidemiology of aging. Epidemiol Rev. 2000;22(1):95-106. https://doi.org/10.1093/oxfordjournals.epirev.a018031 DOI: https://doi.org/10.1093/oxfordjournals.epirev.a018031
Ferrucci L, Giallauria F, Guralnik JM. Epidemiology of aging. Radiol Clin North Am. 2008;46(4):643-52. https://doi.org/10.1016/j.rcl.2008.07.005 DOI: https://doi.org/10.1016/j.rcl.2008.07.005
Brach JS, Studenski SA, Perera S, VanSwearingen JM, Newman AB. Gaitvariability and the risk of incident mobility disability in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2007;62(9):983-8. https://doi.org/10.1093/gerona/62.9.983 DOI: https://doi.org/10.1093/gerona/62.9.983
Kuller LH. Green Banana* DementiaEpidemiologyResearch: It Is Time toModify the Focus of Research. J Gerontol A Biol Sci Med Sci 2006;61(12):1314-8. https://doi.org/10.1093/gerona/61.12.1314 DOI: https://doi.org/10.1093/gerona/61.12.1314
Friese RS, Wynne J, Joseph B, Hashmi A, Diven C, Pandit V, et al. Age and mortality after injury: is the association linear? Eur J Trauma Emerg Surg. 2014;40(5):567-72. https://doi.org/10.1007/s00068-014-0380-0 DOI: https://doi.org/10.1007/s00068-014-0380-0
Xiang H, Wheeler KK, Groner JI, Shi J, Haley KJ. Undertriage of majör trauma patients in the US emergency departments. Am J Emerg Med. 2014;32(9):997-1004. https://doi.org/10.1016/j.ajem.2014.05.038 DOI: https://doi.org/10.1016/j.ajem.2014.05.038
Chang W-H, Tsai S-H, Su Y-J, Huang C-H, Chang K-S, Tsai C-H. Trauma mortality factors in the elderly population. Int J Gerontol. 2008;2(1):11-7. https://doi.org/10.1016/S1873-9598(08)70003-6 DOI: https://doi.org/10.1016/S1873-9598(08)70003-6
Caterino JM, Valasek T, Werman HA. Identification of an age cutoff for increased mortality in patients with elderly trauma. Am J Emerg Med. 2010;28(2):151-8. https://doi.org/10.1016/j.ajem.2008.10.027 DOI: https://doi.org/10.1016/j.ajem.2008.10.027
Perdue PW, Watts DD, Kaufmann CR, Trask AL. Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma Acute Care Surg. 1998;45(4):805-10. https://doi.org/10.1097/00005373-199810000-00034 DOI: https://doi.org/10.1097/00005373-199810000-00034
Jacobs DG, Plaisier BR, Barie PS, Hammond JS, Holevar MR, Sinclair KE, et al. Practice management guidelines for geriatric trauma: the EAST Practice Management GuidelinesWorkGroup. J Trauma Acute Care Surg. 2003;54(2):391-416. https://doi.org/10.1097/01.TA.0000042015.54022.BE DOI: https://doi.org/10.1097/01.TA.0000042015.54022.BE
DeMaria EJ, Merriam M, Casanova L, Gann D, Kenney P. Do DRG payment sadequatelyreimburse the costs of trauma care in geriatric patients? J Trauma. 1988;28(8):1244-9. https://doi.org/10.1097/00005373-198808000-00018
Christensen MC, Ridley S, Lecky FE, Munro V, Morris S. Outcomes and costs of blunt trauma in England and Wales. Crit Care Med. 2008;12(1):1-1. https://doi.org/10.1186/cc6797 DOI: https://doi.org/10.1186/cc6797
Taylor MD, Tracy JK, Meyer W, Pasquale M, Napolitano LM. Trauma in the elderly: intensive care unit resource use and outcome. J Trauma Acute Care Surg. 2002;53(3):407-14. https://doi.org/10.1097/00005373-200209000-00001 DOI: https://doi.org/10.1097/00005373-200209000-00001
LeBlanc J, GuiseEd, Gosselin N, Feyz M. Comparison of functional outcome following acute care in young, middle-aged and elderly patients with traumatic brain injury. Brain Inj. 2006;20(8):779-90. https://doi.org/10.1080/02699050600831835 DOI: https://doi.org/10.1080/02699050600831835
Bradburn EH, Gross BW, Jammula S, Adams WH, Miller JA.Improved outcomes in elderly trauma patients with the implementation of two innovative geriatric-specific protocols. J Trauma Acute Care Surg. 2018;84(2):301-7. https://doi.org/10.1097/TA.0000000000001752 DOI: https://doi.org/10.1097/TA.0000000000001752
Watts HF, Kerem Y, Kulstad EB. Evaluation of the revised trauma and injury severity scores in elderly trauma patients. J Emerg Trauma Shock. 2012;5(2):131. https://doi.org/10.4103/0974-2700.96481 DOI: https://doi.org/10.4103/0974-2700.96481
Koizia L, Kings R, Koizia A, Peck G, Wilson M, Hettiaratchy S, et al. Major trauma in the elderly: frailty decline and patient experience after injury. Trauma. 2019;21(1):21-6. https://doi.org/10.1177/1460408618783221 DOI: https://doi.org/10.1177/1460408618783221
Güneytepe Üİ, Aydın ŞA, Gökgöz Ş, Özgüç H, Ocakoğlu G, Aktaş H. Yaşlı travma olgularında mortaliteye etki eden faktörler ve skorlama sistemleri. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2008;34(1):15-9. https://dergipark.org.tr/en/pub/uutfd/issue/35269/391365
Javali RH, Krishnamoorthy AP, Srinivasarangan M, Suraj S. Comparison of injury severity score, new injury severity score, revised trauma score and trauma and injury severity score formortality prediction in elderly trauma patients. Indian J Crit Care Med. 2019;23(2):73. https://doi.org/10.5005/jp-journals-10071-23120 DOI: https://doi.org/10.5005/jp-journals-10071-23120
Richmond TS, Kauder D, Strumpf N, Meredith T. Characteristics and outcomes of serious traumatic injury in older adults. J Am Geriatr Soc. 2002;50(2):215-22. https://doi.org/10.1046/j.1532-5415.2002.50051.x DOI: https://doi.org/10.1046/j.1532-5415.2002.50051.x
Akköse Aydin S, Bulut M, Fedakar R, Ozgürer A, Ozdemir F. Trauma in the elderly patients in Bursa. Ulus Travma Acil Cerrahi Derg. 2006;12(3):230-4. PMID: 16850362
Cuevas-Østrem M, Røise O, Wisborg T, Jeppesen E. Epidemiology of geriatric trauma patients in Norway: A nation wide analysis of Norwegian Trauma Registry data, 2015–2018. A retrospective cohort study. Injury. 2021;52(3):450-9. https://doi.org/10.1016/j.injury.2020.11.007 DOI: https://doi.org/10.1016/j.injury.2020.11.007
Ferrera PC, Bartfield JM, D'andrea CC. Outcomes of admitted geriatric trauma. Am J Emerg Med. 2000;18(5):575-80. https://doi.org/10.1053/ajem.2000.9266 DOI: https://doi.org/10.1053/ajem.2000.9266
Diamantopoulos AP, Rohde G, Johnsrud I, Skoie IM, Hochberg M, Haugeberg G. The epidemiology of low-and high-energy distal Radius fracture in middle-aged and elderly men and women in Southern Norway. 2012. PLoS One. https://doi.org/10.1371/journal.pone.0043367 DOI: https://doi.org/10.1371/journal.pone.0043367
Kara H, Bayir A, Ak A, Akinci M, Tufekci N, Degirmenci S, et al. Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study. Clin Interv Aging. 2014;9:17-21. https://doi.org/10.2147/CIA.S56542 DOI: https://doi.org/10.2147/CIA.S56542
Evans D, Hodgkinson B, Lambert L, Wood J. Falls risk factors in the hospital setting: a systematic review. Int J Nurs Pract. 2001;7(1):38-45. https://doi.org/10.1046/j.1440-172x.2001.00269.x DOI: https://doi.org/10.1046/j.1440-172x.2001.00269.x
Abou-Raya S, ElMeguid LA. Road traffic accidents and the elderly. Geriatr Gerontol Int. 2009;9(3):290-7. https://doi.org/10.1111/j.1447-0594.2009.00535.x DOI: https://doi.org/10.1111/j.1447-0594.2009.00535.x
Etehad H, Yousefzadeh-Chabok S, Davoudi-Kiakalaye A, Moghadam DA, Hemati H, Mohtasham-Amiri Z. Impact of road traffic accidents on the elderly. Arch Gerontol Geriatr. 2015;61(3):489-93. https://doi.org/10.1016/j.archger.2015.08.008 DOI: https://doi.org/10.1016/j.archger.2015.08.008
Richter M, Pape H-C, Otte D, Krettek C. The current status of road user injuries among the elderly in Germany: a medical and technical accident analysis. J Trauma Acute Care Surg. 2005;58(3):591-5. https://doi.org/10.1097/00005373-200503000-00024 DOI: https://doi.org/10.1097/00005373-200503000-00024
Güler H, Ahsen K, Şenol E, Belpınar MS, Aktaş EÖ. 65 yaş ve üzeri olgular için düzenlenen adli raporların retrospektif incelenmesi. Ege Tıp Dergisi. 2020;59(3):196-201. https://doi.org/10.19161/etd.790460 DOI: https://doi.org/10.19161/etd.790460
PuiguriguerFerrando J, MirallesCorrales S, FronteraJuan G, Campillo-Artero C, BarcelóMartín B. Poisoning among the elderly. Rev Clin Esp (English Edition). 2021;221(8):441-7. https://doi.org/10.1016/j.rceng.2020.08.004 DOI: https://doi.org/10.1016/j.rceng.2020.08.004
Hu Y-H, Chou H-L, Lu W-H, Huang H-H, Yang C-C, Yen DH, et al. Features and prognostic factors for elderly with acut epoisoning in the emergency department. J Chin Med Assoc. 2010;73(2):78-87. https://doi.org/10.1016/S1726-4901(10)70006-X DOI: https://doi.org/10.1016/S1726-4901(10)70006-X
Breedt DS, Steyn E. Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare? World J Surg. 2022:1-9. https://doi.org/10.1007/s00268-021-06416-6 DOI: https://doi.org/10.1007/s00268-021-06416-6
Gioffrè-Florio M, Murabito L, Visalli C, Pergolizzi F, Famà F. Trauma in elderly patients: a study of prevalence, comorbidities and gender differences. G Chir 2018;39(1):35. https://doi.org/10.11138/gchir/2018.39.1.035 DOI: https://doi.org/10.11138/gchir/2018.39.1.035
Çevik Y, Doğan NÖ, Daş M, Karakayalı O, Delice O, Kavalcı C. Evaluation of geriatric patients with trauma scores after motor vehicle trauma. Am J Emerg Med. 2013;31(10):1453-6. https://doi.org/10.1016/j.ajem.2013.07.021 DOI: https://doi.org/10.1016/j.ajem.2013.07.021
Demarıa EJ, Merrıam MA, Casanova LA, Gann DS, Kenney PR. Do DRG PaymentsAdequatelyReimbursetheCosts of TraumaCare in GeriatricPatients? J Trauma Acute Care Surg. 1988;28(8):1244-9. https://doi.org/10.1097/00005373-198808000-00018 DOI: https://doi.org/10.1097/00005373-198808000-00018
Varışlı B. Acil Servise Başvuran Geriatrik Yaş Grubu Hastaların Klinik, Demografik ve Maliyet Açısından İncelenmesi. Anatolian Journal of Emergency Medicine.1(2):18-24.
Grossman MD, Miller D, Scaff DW, Arcona S. When is an elder old? Effect of preexisting conditions on mortality in geriatric trauma. J Trauma. 2002;52(2):242-6. https://doi.org/10.1097/00005373-200202000-00007 DOI: https://doi.org/10.1097/00005373-200202000-00007
Morris JA, Jr., MacKenzie EJ, Damiano AM, Bass SM. Mortality in trauma patients: the interaction between host factors and severity. J Trauma. 1990;30(12):1476-82. https://doi.org/10.1097/00005373-99012000-00006 DOI: https://doi.org/10.1097/00005373-199012000-00006
Milzman DP, Boulanger BR, Rodriguez A, Soderstrom CA, Mitchell KA, Magnant CM. Pre-existing disease in trauma patients: a predictor of fate independent of age and injury severity score. J Trauma. 1992;32(2):236-43; discussion 43-4. https://doi.org/10.1097/00005373-199202000-00021 DOI: https://doi.org/10.1097/00005373-199202000-00021
Rogers A, Rogers F, Bradburn E, Krasne M, Lee J, Wu D, et al. Old and Under triaged: A Lethal Combination. Am Surg. 2012;78(6):711-5. https://doi.org/10.1177/000313481207800628 DOI: https://doi.org/10.1177/000313481207800628
Caterino JM, Brown NV, Hamilton MW, Ichwan B, Khaliqdina S, Evans DC, et al. Effect of geriatric‐specific trauma triage criteria on outcomes in injured older adults: A state wide retrospective cohort study. J Am Geriatr Soc. 2016;64(10):1944-51. https://doi.org/10.1111/jgs.14376 DOI: https://doi.org/10.1111/jgs.14376
Hsia RY, Wang E, Saynina O, Wise P, Auerbach A. Factors associated with trauma center use for elderly patients with trauma: a state wide analysis, 1999-2008. Arch Surg. 2011;146(5):585-92. https://doi.org/10.1001/archsurg.2010.311 DOI: https://doi.org/10.1001/archsurg.2010.311
Keller JM, Sciadini MF, Sinclair E, O'Toole RV. Geriatric trauma: demographics, injuries, and mortality. J Orthop Trauma. 2012;26(9):e161-e5. https://doi.org/10.1097/BOT.0b013e3182324460 DOI: https://doi.org/10.1097/BOT.0b013e3182324460
McKee M, Schemitsch E, Stephen DJ, Kreder H, Yoo D, Harrington J. Functional outcome following clavicle fractures in poly trauma patients. J Trauma Acute Care Surg. 1999;47(3):616. https://doi.org/10.1097/00005373-199909000-00057 DOI: https://doi.org/10.1097/00005373-199909000-00057
Lehmann R, Beekley A, Casey L, Salim A, Martin M. The impact of advanced age on trauma triage decisions and outcomes: a state wide analysis. Am J Surg. 2009;197(5):571-5. https://doi.org/10.1016/j.amjsurg.2008.12.037 DOI: https://doi.org/10.1016/j.amjsurg.2008.12.037
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