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.