The role of cardiac morbidity in short- and long-term mortality in injured older patients who survive initial resuscitation.
BACKGROUND
Elderly patients are an increasingly larger group of injured trauma care patients. Comorbidities influence outcome. Little is known of short- and long-term mortality in the elderly who survive initial resuscitation.


METHODS
Short- and long-term mortality was retrospectively analyzed in 363 consecutively injured patients (Injury severity score >15) surviving more than 3 days after admission to a level 1 trauma center (including 197 patients >60 years). Cardiac morbidity was the focus.


RESULTS
Survival to hospital discharge was similar comparing older patients with the entire group. Mortality increased incrementally with age. In older patients, cardiac morbidity was observed in 28% (fatal in 7); 2-year mortality was 36% (older group) and 60% (patients sustaining cardiac complications). Most elderly (80%) were discharged to long-term care.


CONCLUSIONS
Elderly who survive initial resuscitation are as likely to survive to discharge as younger patients, but long-term survival is significantly lower as age increases. Cardiac morbidity is associated with higher long-term mortality. Most elderly are discharged to long-term care.
Gallagher
Scott F
SF
Department of Surgery, University of South Florida College of Medicine, and the Regional Trauma Center at Tampa General Hospital, Tampa, FL, USA.
Williams
Brian
B
Gomez
Cathie
C
DesJardins
Christine
C
Swan
Sherry
S
Durham
Rodney M
RM
Flint
Lewis M
LM
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D008134:Long-Term Care; D008875:Middle Aged; D009017:Morbidity; D010351:Patient Discharge; D012151:Resuscitation / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000401:mortality*