Outcomes of admitted geriatric trauma victims

Conflicting data exist as to the outcome of elderly victims of trauma. With recent improved outcomes for functional recovery, aggressive management of these patients has been advocated. The purpose of this study is to determi ne outcomes of admitted elderly trauma victims based on initial mechanism o f injury and the degree to which other factors affected their overall outco me. A prospective study involving admitted patients greater than or equal t o 65 years was performed at an urban university center from September 15, 1 996 until August 31, 1997. Patients sustaining any potentially serious form of trauma were included. Data about mechanism of injury (MOI), comorbid co nditions, preinjury medications, types of injuries sustained, length of sta y, functional outcome, and ultimate disposition were recorded. Two hundred thirty-nine consecutive patients were enrolled, Mean age was 78.1 +/- 8.1 y ears. There were 130 women (54%) and 109 men (46%). MOI was as follows: 132 low-mechanism falls (LMFs), 64 high-mechanism motor vehicle crashes (HMMVC s), 22 high-mechanism falls (HMFs), 8 pedestrian versus car (PVCs), and 13 other types. Mean length of stay surviving beyond the ED was 12.9 days. 8 p atients were either DOA or died in the ED. There were 19 in-hospital deaths . Deaths were seen in 14% of HMMVCs, 13.6% HMFs, 9.1% LMFs, 25% PVCs, and 7 .7% for other mechanisms. Overall outcomes by mechanism were categorized as functional (or baseline), fair, alive but poor, and dead. Functional outco mes were seen in 76.6% of HMMVCs, 81.8% of HMFs, 84.1% of LMFs, 50% of PVCs , and 84.6% for all other injuries. Forty-five percent were discharged home , 26% went to rehabilitation units, 16% went to nursing homes, and 11% died ; the remaining 2% were either transferred to a psychiatric facility or to another hospital. Preexisting comorbid conditions did not appear to play a significant role in the ultimate outcomes of these patients. Severity of in jury was the leading determinant of death, but severely injured patients of ten had functional outcomes. Elderly trauma victims most often achieve func tional outcomes despite multiple or severe injuries. Copyright (C) 2000 by W.B. Saunders Company.