UMEM Educational Pearls

Category: Trauma

Title: Geriatric trauma mortality predictors

Keywords: Geriatric, trauma, mortality, risk factors (PubMed Search)

Posted: 11/26/2023 by Robert Flint, MD (Updated: 2/23/2024)
Click here to contact Robert Flint, MD

A chart review of 1300 patients over age 65 admitted to the trauma service, arrived as a trauma activation, or had an injury severity score over 12 over a 6 year period looking at 30 day mortality found: 

"five factors associated with increased 30-day mortality in older trauma patients: GCS < 15, ISS > 15, age ≥ 85 years, anticoagulation, and multimorbidity."

Fall from standing was the leading cause of trauma  

Again, fragility is the index we should be using, not age alone. This study is limited in its retrospective chart review nature. Prospective research in the area of geriatric trauma is needed. Until then, assess those over age 65 for risk factors associated with fragility and treat accordingly. 

References

Yadav, K., Lampron, J., Nadj, R. et al.Predictors of mortality among older major trauma patients. Can J Emerg Med 25, 865–872 (2023). https://doi.org/10.1007/s43678-023-00597-w