Geriatric Trauma

Geriatric Trauma is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Geriatric-specific considerations and approach to the elderly trauma patient, generally age >65
  • Should be used in conjunction with the accepted standard treatment of traumatic injuries (see “Trauma, Multiple”)
  • Advanced age is a known risk factor for adverse outcomes following trauma
  • Overall frailty and comorbid illnesses decrease physiologic reserve and result in poorer outcomes
  • Advances in the management of chronic diseases have resulted in more active lifestyles in elderly individuals predisposing them to injury

Etiology

  • Trauma is the fifth leading cause of death in the elderly
  • Elderly are more susceptible to serious injury from low-energy mechanisms
Most common mechanisms:
  • Falls – most common cause, often occurs on an even, flat surface and frequently recurrent within 1 yr
  • Motor vehicle crashes – second leading cause, most common fatal etiology
  • Pedestrian – motor vehicle collisions, diminished cognitive skills, poor vision/hearing, impaired gait contribute to increased incidence
  • Burns – higher fatality rate than young adults with same extent of burn
  • Violence – less common mechanism than in younger ages, have heightened suspicion for elderly abuse, an under recognized issue

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Basics

Description

  • Geriatric-specific considerations and approach to the elderly trauma patient, generally age >65
  • Should be used in conjunction with the accepted standard treatment of traumatic injuries (see “Trauma, Multiple”)
  • Advanced age is a known risk factor for adverse outcomes following trauma
  • Overall frailty and comorbid illnesses decrease physiologic reserve and result in poorer outcomes
  • Advances in the management of chronic diseases have resulted in more active lifestyles in elderly individuals predisposing them to injury

Etiology

  • Trauma is the fifth leading cause of death in the elderly
  • Elderly are more susceptible to serious injury from low-energy mechanisms
Most common mechanisms:
  • Falls – most common cause, often occurs on an even, flat surface and frequently recurrent within 1 yr
  • Motor vehicle crashes – second leading cause, most common fatal etiology
  • Pedestrian – motor vehicle collisions, diminished cognitive skills, poor vision/hearing, impaired gait contribute to increased incidence
  • Burns – higher fatality rate than young adults with same extent of burn
  • Violence – less common mechanism than in younger ages, have heightened suspicion for elderly abuse, an under recognized issue

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