Preventable complications and death from multiple organ failure among geriatric trauma victims.
We reviewed 374 consecutive trauma patients over age 65 years to determine (1) if the emergency room Trauma Score (TS) could predict mortality, thereby improving ICU triage, and (2) the frequency of preventable complications in patients who died (n = 31). Fifty-two percent of deaths (n = 16) occurred in patients with TS = 15 or 16. Multiple organ failure/sepsis (MOF/S) was the most common cause of death overall (42%) and was also the most frequent cause of death in patients with a TS = 15-16 (63%). Nonsurvivors in the TS = 15-16 subgroup were older (80.9 +/- 2.0 vs. 74.9 +/- 0.5 years, p less than 0.02) and had greater ISSs (15.8 +/- 3.7 vs. 8.0 +/- 0.4, p = 0.001) than survivors. Patients with a TS less than 15 suffered high overall mortality (45%). Preventable complications contributed to mortality in 32% of all deaths and in 62% of MOF/S deaths. Aggressive care to prevent avoidable complications may improve survival in elderly trauma victims.
Pellicane
J V
JV
Department of Surgery, Medical College of Virginia, Richmond 23298-0475.
Byrne
K
K
DeMaria
E J
EJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control; D005069:Evaluation Studies as Topic; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D009102:Multiple Organ Failure / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D009104:Multiple Trauma / Q000145:classification* / Q000150:complications / Q000175:diagnosis; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D015599:Trauma Severity Indices; D014218:Triage / Q000592:standards; D014768:Virginia / Q000453:epidemiology