Impact of age on the clinical outcomes of major trauma

被引:56
作者
Hildebrand, F. [1 ,2 ]
Pape, H. -C. [1 ]
Horst, K. [1 ,2 ]
Andruszkow, H. [1 ,2 ]
Kobbe, P.
Simon, T. -P. [3 ]
Marx, G. [3 ]
Schuerholz, T. [3 ]
机构
[1] Univ Aachen, Dept Orthopaed Trauma, Pauwelsstr 30, D-52074 Aachen, Germany
[2] Univ Aachen, Harald Tscherne Res Lab Orthopaed Trauma, Aachen, Germany
[3] Univ Aachen, Dept Intens Care Med, Aachen, Germany
关键词
Multiple trauma; Geriatric trauma; Preexisting medical conditions; Outcome; PREINJURY WARFARIN USE; IN-HOSPITAL MORTALITY; NEW-YORK-STATE; GERIATRIC TRAUMA; ELDERLY-PATIENTS; BRAIN-INJURY; PREEXISTING CONDITIONS; INTRACRANIAL HEMORRHAGE; PENETRATING TRAUMA; ORTHOPEDIC TRAUMA;
D O I
10.1007/s00068-015-0557-1
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose In view of demographic changes over the past few decades, the average age of trauma patients is progressively increasing. We therefore aimed to summarize the specific characteristics of geriatric trauma and to identify potential fields for further research to improve the care of elderly trauma patients. Methods Review of the literature. Results Due to the diverse risk factors (e.g., pre-existing conditions, limited physiological reserve), geriatric patients are prone to developing severe complications, even after less severe trauma. Yet, age is not considered as the only predictor of worse outcomes, and it should not be considered the only criterion for limiting care in those patients. It is crucial that age-specific treatment guidelines are developed to optimize the outcomes for senior trauma patients. Based on the current literature, these guidelines should emphasize the importance of field triage directly to a trauma center, along with the activation of the trauma team. Furthermore, early intensive monitoring, aggressive resuscitation, and time of surgical intervention are of upmost importance to reduce mortality. Conclusion The impact of several factors [age, premedical conditions (PMC), decreased physiological reserves, and impaired immune function] on the post-traumatic course of elderly trauma patients needs to be clarified in future experimental and clinical studies for the early identification of geriatric high-risk patients and for the development of age-adapted therapeutic strategies.
引用
收藏
页码:317 / 332
页数:16
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