[Follow-up and prognosis of severe accidental trauma in the aged].
Multiple injuries in elderly patients are still a common problem. The present study was performed to investigate mortality and complications in multiple trauma patients aged 65 years or more. A total of 1154 multiple trauma patients with an injury severity score (ISS) of at least 18 points were divided in two age groups: Y: 16-64 years, n = 1022; O: 65-94 years, n = 132. Older patients were injured as pedestrians in most cases (69%), while younger patients were more frequently injured as car and drivers passengers (41%). ISS was comparable in both groups (Y 28 +/- 1, O 27 +/- 1). During ICU-therapy incidence of ARDS (Y 10%, O 11%), multiple organ dysfunction syndrome (MOF; Y 6%, O 9%) and pneumonia (Y 17%, O 21%) were comparable. In contrast, septic complications were more frequent in older patients (Y 19%, O 27%). Length of ICU stay (Y 19 +/- 2, O 18 +/- 1) and ventilation time (Y 14 +/- 2, O 17 +/- 1) were comparable. Mortality was significantly higher in older patients (Y 15%, O 53%). The major cause of death was sepsis in older patients (Y 15%, O 31%) and MOF in younger patients (Y 54%, O 29%). In conclusion, older trauma patients had a higher mortality due to the development of septical complications.
Aufmkolk
M
M
Abteilung für Unfallchirurgie, Universitätsklinik Essen.
Majetschak
M
M
Voggenreiter
G
G
Obertacke
U
U
Schmit-Neuerburg
K P
KP
D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality* / Q000601:surgery; D012307:Risk Factors; D016019:Survival Analysis