EFFECTS OF AGING ON THE INITIAL METABOLIC RESPONSE TO ACCIDENTAL INJURY

Background: little is known about the effects of ageing on the early m etabolic response to injury. This response is thought to have evolved as a defence mechanism and may be particularly important in old people , who often present late to hospital after accidental injury. Setting: the accident and emergency department of a teaching hospital. Subject s: 352 patients studied within 2 h of accidental injury, before the st art of definitive treatment. Methods: a single blood sample was taken from each patient and the plasma concentrations of glucose, insulin, l actate, non-esterified fatty acids and cortisol were measured. Factori al analysis of variance was used to distinguish the effects of age (17 -40, 41-65 and 66-92 years) from those of Injury Severity Score (1-6, 8-12, 13-24 and 25-66). Results: elderly patients had a higher concent ration of glucose than young ones. There were no consistent age-effect s for the other analytes. Although men were over-represented among the young and women among the elderly, a similar analysis by sex in the 4 1-65-year-old group suggested that this uneven distribution did not bi as the results. Conclusion: elderly people do not have a defective ear ly biochemical response to injury.