International Journal of Gerontology
Volume 2, Issue 1 , Pages 11-17, March 2008

Trauma Mortality Factors in the Elderly Population

  • Wen-Han Chang

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • National Taipei University of Technology, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • ,
  • Shin-Han Tsai

      Affiliations

    • Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Shin-Han Tsai, Graduate Institute of Injury Prevention and Control, Taipei Medical University, 250, Wu-Hsing Street Taipei 110, Taiwan
    • ,
  • Yu-Jang Su

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • ,
  • Chien-Hsuan Huang

      Affiliations

    • Department of Rehabilitation, Tai-En Memorial Hospital, Taipei, Taiwan
    • ,
  • Kou-Song Chang

      Affiliations

    • Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Cheng-Ho Tsai

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

Accepted 20 December 2007.

Article Outline

Summary 

Trauma in the elderly population is frequent and is associated with significant mortality, owing not only to age-related factors, but also those complicated factors relating to lack of physical reserves, the injury severity, preexisting comorbidity, and insufficient ability for systemic compensation. Age-related mortality remains constant in the low to moderately severe injury categories compared with the severely injured groups (injury severity score, ISS, 25 or greater). The age-related insufficient physical reserves for cardiac output leave this group in the state of hypoperfusion, which is hard to identify. The circumstances around metabolic demands and lower maximum heart rate with a higher peripheral vascular resistance make the cardiovascular system reserve unable to respond, which means that a diagnosis of shock is more difficult to establish. Higher ISSs obtained at injury in the elderly population can predict higher mortality better than in younger population, but they have not been as effective in predicting mortality obtained at follow-up of elderly trauma patients compared with those at the time at injury. More aggressive care for the elderly trauma patient has been shown to decrease mortality. Because of the multiple mortality factors, a decision on treatment type following trauma in geriatric patients is unable to be made if the clinician is not alert to the pitfalls which can affect these individuals. Regardless of age or injury severity and with special considerations for those patients who arrive in a moribund condition, geriatric trauma patients should be treated with as much effort as their younger counterparts, that is, aggressively and within a certain time frame. [International Journal of Gerontology 2008; 2(1): 11–17]

Key Words:  elderly trauma , geriatric consideration , mortality , pitfall

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PII: S1873-9598(08)70003-6

doi:10.1016/S1873-9598(08)70003-6

International Journal of Gerontology
Volume 2, Issue 1 , Pages 11-17, March 2008

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