Multiple trauma in elderly patients. Factors influencing outcome: importance of aggressive care

Broos, Paul; D’Hoore, André; Vanderschot, Paul; Rommens, Pol Maria; Stappaerts, Karel

doi:10.1016/0020-1383(93)90096-o

Cited by 87 publications

(58 citation statements)

References 11 publications

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“…Result highlights fact that geriatric trauma patients need rapid and appropriate prehospital evaluation and initiation of therapy in order to prevent fatal course of events. [3,9,14,[33][34][35][36][37][38][39] Hypovolemic shock plays central role in bad outcome and increased mortality rate [8,9,12,20,25,28,[40][41][42][43] as seen in our patients with massive bleeding. It was determined that additional intraabdominal bleeding doubles mortality rate (Table 2, 9).…”

Section: Discussionmentioning

confidence: 99%

“…[3,5,6,18,20,21,[33][34][35][36]38,39,45,46] Volume resuscitation as soon as possible should raise systolic BP to at least 80 mmHg. In case of concomitant head and brain injury, systolic BP should even be at least 120 mmHg in order to maintain adequate cerebral perfusion and to prevent secondary brain injury.…”

Section: Discussionmentioning

confidence: 99%

“…GCS is of major prognostic relevance (Table 5), especially in relation to head and brain injuries. [3,8,15,16,23,25,29,32,35,[42][43][44][47][48][49] Additionally, it allows for reproducible preclinic evaluation to determine necessity of intubation. It also provides evidence on possible volume deficit, which can lead to reduced cerebral perfusion and consequently to impaired or loss of consciousness (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, liberal indication for intubation and ventilation with 100% oxygen is recommended. [3,20,33,35] Sufficient anesthesia achieves best possible management of pain. As pain stimulates release of shock mediators, anesthesia can also suppress shock mediator-induced cardiovascular depression.…”

Section: Rupprecht Et Al the Geriatric Polytraumamentioning

confidence: 99%

See 3 more Smart Citations

The geriatric polytrauma: Risk profile and prognostic factors

Rupprecht

Heppner²,

Wohlfart³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Rupprecht Et Al the Geriatric Polytraumamentioning

confidence: 99%

See 2 more Smart Citations

The geriatric polytrauma: Risk profile and prognostic factors

Rupprecht

Heppner²,

Wohlfart³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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show abstract

“…Aggressive early management of such patients results in increased survival rate, and of those who survive, the majority return home. [4] Mortality due to trauma continues to fall, but the highest rates are seen in patients older than 65 years. The majority of traumas are secondary to falls.…”

Section: Discussionmentioning

confidence: 99%

Traumatic rupture of gastric pull-up after apparent mild thoracic trauma; case report and literature review

Valle

Srinivasrao

Snow

et al. 2015

Ulus Travma Acil Cerrahi Derg

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While elderly patients account for only 10-12% of all trauma victims, they consume 25% of trauma-related health care resources, with higher rates of mortality and complication. Presently described is the case of an elderly patient who presented to the emergency department (ED) following mild thoracic trauma, with previous history of gastric pull-up surgery. The patient had consulted another facility 48 hours earlier and was prescribed analgesia and x-ray follow-up for a mechanical fall and pain in the lower rib cage. At arrival, the patient complained of increasing dyspnea and pain at the right hemithorax. X-ray showed right hemithorax effusion, and contrast computed tomography (CT) demonstrated a large amount of contrast filling the pleural space and a relatively small point of gastric pull-up rupture in the stomach. The patient was referred to the cardiothoracic unit, but was unresponsive upon arrival and died. The aim of the present report was to raise the index of clinical suspicion of traumatic rupture of the gastric pull-up following traumatic chest injury, and to affirm that contrast CT should be the gold standard for diagnosis.

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Recurrent Trauma in Elderly Patients

McGwin

May²,

Melton³

et al. 2001

Arch Surg

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Hypothesis: Older patients (those aged Ն70 years) who have experienced trauma have an increased risk of recurrent trauma. Demographic, medical, and functional factors are potential contributors to the risk of subsequent trauma among injured elderly patients. Design: Retrospective follow-up study. Participants: Study participants were derived from the Longitudinal Study of Aging, an extension of the 1984 National Health Interview Survey focusing on persons who were aged 70 years and older in 1984. A cohort of elderly patients participating in the Longitudinal Study of Aging and hospitalized for injury in 1985 (n=100) was identified using Medicare hospital discharge data. An uninjured cohort (n=401) was also identified from the Longitudinal Study of Aging and matched for age (1 year) and sex. Main Outcome Measures: Risk of admission for trauma among the injured cohort compared with the uninjured cohort and associations between demographic, medical, and functional characteristics and trauma recurrence. Results: Following adjustment for potential confounding factors, the injured cohort was 3.25 times more likely (95% confidence interval, 1.99-5.31) to be hospitalized for injury during the follow-up period compared with the uninjured cohort. Among the injured cohort, those at greatest risk of subsequent trauma included women and those with chronic medical conditions or functional impairments, the latter being the only factor independently associated with recurrence. Conclusions: Elderly patients who have experienced trauma are at increased risk of subsequent injury. Interventions to reduce the likelihood of trauma recurrence should focus on those with chronic illnesses and functional impairments.

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Multiple trauma in elderly patients. Factors influencing outcome: importance of aggressive care

Cited by 87 publications

References 11 publications

The geriatric polytrauma: Risk profile and prognostic factors

The geriatric polytrauma: Risk profile and prognostic factors

Traumatic rupture of gastric pull-up after apparent mild thoracic trauma; case report and literature review

Recurrent Trauma in Elderly Patients

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