Geriatric trauma: aggressive intensive care unit management is justified.
The United States population older than 65 years increased 21 per cent from 1980 to 1990. Attempts to characterize geriatric trauma have failed to yield a consensus on basic descriptors or physiologic parameters predictive of outcome. We reviewed the records of 170 trauma patients, aged 60 or above, admitted to our institution in a recent 50-month period. Mortality was 21.8 per cent. None of the 54 general care patients died; 79 (68%) of the 116 ICU patients survived. ICU deaths correlated with number of organ systems failing and severe head injury. Although these results justify aggressive ICU treatment, average hospital stay was 15 days, and one third of patients required skilled nursing facilities for ultimate recovery, so the resource cost is high.
Shapiro
M B
MB
Department of Surgery, University of Michigan Medical School, Ann Arbor.
Dechert
R E
RE
Colwell
C
C
Bartlett
R H
RH
Rodriguez
J L
JL
D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003422:Critical Care / Q000592:standards*; D005260:Female; D015276:Health Care Rationing; D006785:Hospitals, University / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*