Functional Outcomes in Octogenarian Trauma

Grossman, Michael D.; Scaff, David W.; Miller, Donna L.; Reed, James F.; Hoey, Brian A.; Anderson, Harry L.

doi:10.1097/01.ta.0000072109.52351.0d

Cited by 57 publications

(43 citation statements)

References 20 publications

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“…With more active lifestyles and improved longevity, the elderly are going to incur more high-energy injuries [10,11,13]. Specifically, the impact of a high-energy femur fracture, an injury that potentially may occur more frequently in the future, has yet to be examined in this age group.…”

Section: Discussionmentioning

confidence: 99%

“…Advanced age [4,12], Injury Severity Score (ISS) [4,6,14], male gender [12], preexisting conditions [2,[10][11][12], and in-hospital complications [6,20,21] have been associated with increased mortality rates in these patients. When compared with a younger population with trauma, elderly patients with trauma have higher mortality rates [10,11,16,18,26]. Furthermore, mortality in elderly patients with trauma occurs later during the course of treatment [26] and has been attributed to diminished physiologic reserves [8,12,15].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Projected to be nearly 40% of total hospital trauma admissions by 2050 [10], elderly patients with trauma not only use 25% of hospital resources [28], but also are at increased risk for serious injuries [13]. Advanced age [4,12], Injury Severity Score (ISS) [4,6,14], male gender [12], preexisting conditions [2,[10][11][12], and in-hospital complications [6,20,21] have been associated with increased mortality rates in these patients. When compared with a younger population with trauma, elderly patients with trauma have higher mortality rates [10,11,16,18,26].…”

Section: Introductionmentioning

confidence: 99%

“…With increasing life expectancy [5,8] and active lifestyle of the elderly [4,5,8,9], trauma centers are seeing an increase in the number of elderly patients with trauma secondary to higher-energy injuries [10,11,13,19,22,24]. Projected to be nearly 40% of total hospital trauma admissions by 2050 [10], elderly patients with trauma not only use 25% of hospital resources [28], but also are at increased risk for serious injuries [13]. Advanced age [4,12], Injury Severity Score (ISS) [4,6,14], male gender [12], preexisting conditions [2,[10][11][12], and in-hospital complications [6,20,21] have been associated with increased mortality rates in these patients.…”

Section: Introductionmentioning

confidence: 99%

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High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients

Patel

Brennan

Davis

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Trauma centers are projected to have an increase in the number of elderly patients with high-energy femur fractures. Greater morbidity and mortality have been observed in these patients. Further clarification regarding the impact of high-energy femur fractures is necessary in this population. Questions/purposes Our purpose was to assess the influence of high-energy femur fractures on mortality and morbidity in patients 60 years and older. Specifically, we asked (1) if the presence of a high-energy femur fracture increases in-hospital, 6-month, and 1-year mortality in patients 60 years and older, and (2) if there is a difference in morbidity (number of complications, intensive care unit [ICU] and total hospital length of stay, discharge disposition, accompanying fractures, and surgical intervention) between patients 60 years and older with and without highenergy femur fractures.Methods A retrospective review of 242 patients was performed. Patients with traumatic brain injury or spine injury with a neurologic deficit were excluded. A control group, including patients admitted secondary to highenergy trauma without femur fractures, was matched by gender and Injury Severity Score (ISS). In-hospital mortality, 6-month and 1-year mortality, complications, ICU and total hospital length of stay, discharge disposition, accompanying fractures, surgical intervention, and covariates were recorded. Statistical analyses using Fisher's exact test, ANOVA, Kaplan-Meier estimates, and Cox regression models were performed to show differences in mortality (in-hospital, 6-month, 1-year), complications, length of ICU and total hospital stay, discharge disposition, surgical intervention, and accompanying fractures between elderly patients with and without femur fractures. The average ages of the patients were 72.8 years (± 9 years) in the femur fracture group and 71.8 years (± 9 years) in the control group. Sex, age, ISS, and comorbidities were homogenous between groups. Results In-hospital (p = 0.45), 6-month (p = 0.79), and 1-year mortality (p = 0.55) did not differ in patients with and without high-energy femur fractures. Elderly patients with high-energy femur fractures had an increased number of complications (p = 0.029), longer total hospital length of stay (p = 0.039), were discharged more commonly to rehabilitation centers (p \ 0.005), had more accompanying long bone fractures (p = 0.002), and were more likely to have surgery (p \ 0.001). Average ICU length of stay was similar between the two groups (p = 0.17). Conclusions High-energy femur fractures increased morbidity in patients 60 years and older; however, no increase in mortality was observed in our patients. Concomitant injuries may play a more critical role in this population. Additional studies are necessary to clarify the Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose ...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients

Patel

Brennan

Davis

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Relationship of age, injury severity, injury type, comorbid conditions, level of care, and survival among older motor vehicle trauma patients

Scheetz

2005

Research in Nursing & Health

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The purpose of this secondary data analysis was to compare age, injury severity, injury types, selected comorbidities, level of care (at trauma center [TC] and non-trauma center [NTC] hospitals), and survival among older motor vehicle trauma patients (N = 1,478). Patients admitted to both levels of care had similar comorbid conditions. TC patients had a higher injury severity, whereas NTC patients had a greater proportion of soft tissue injuries. Results of logistic regression analyses subsequent to group comparisons revealed that higher injury severity was associated with TC admission. The likelihood of TC admission of severely injured patients decreased in the presence of spinal, internal, and head injuries. Internal injuries, liver, renal, and cardiovascular diseases were associated with non-survival while hypertension was associated with survival. Special attention is needed when triaging older trauma patients because their injuries may be covert, thus putting them at risk for admission to a level of care that may be inappropriate given the extent of their injuries.

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Outcomes for Surgical Care in the Elderly

Maxwell

Rader

Fallon

2013

Geriatric Trauma and Critical Care

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Functional Outcomes in Octogenarian Trauma

Abstract: Functional outcomes after blunt trauma are worse for OTPs; however, functional independence in feeding and social interaction are preserved in OTPs even with moderate injury severity.

Cited by 57 publications

References 20 publications

High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients

High-energy Femur Fractures Increase Morbidity but not Mortality in Elderly Patients

Relationship of age, injury severity, injury type, comorbid conditions, level of care, and survival among older motor vehicle trauma patients

Outcomes for Surgical Care in the Elderly

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