title: Prognosis and health-related quality of life in elderly patients after a mild to moderate trauma.
abstract: The aims of this study were to compare outcome after a mild to moderate trauma in three subgroups of patients of increasing age (A1: <50, A2: 50-74, A3: >74 years) and to assess potential health-related quality of life (HRQOL) impairment. This is a follow-up study of a cohort of 418 trauma patients admitted to the High Dependency Unit of the Emergency Department of the University Hospital of Florence from July 2008 to February 2012. Six months after the event, a telephone interview using the Physical component summary (PCS) and Mental component summary (MCS) Health Composite Score (SF12) was conducted. Patients reported their QOL both at present and before trauma. In-hospital mortality was 10 of 418 (2.3 %); overall mortality was 27 of 244 (11 %) patients found at follow-up. No death was observed among A1 patients; overall mortality was (6/76) 7 % in A2 and (21/71) 30 % in A3 patients (p < 0.05 A1 vs A2, A1 vs A3 and A2 vs A3). Before the event, respectively, 94 and 96 % patients reported a normal MCS and PCS score (>39); after the event, the proportion of patients with a normal score value was significantly lower (MCS 70 %, p = 0.002; PCS 58 %, p < 0.0001). All subgroups showed a highly significant reduction in the scores' value due to the trauma. After the event, the proportion of patients with normal scores was significantly lower (all p < 0.0001, except for MCS score in A1 subgroup, who showed p = 0.013) within all subgroups. Elderly patients' prognosis was significantly worse compared with the younger counterpart; despite young patients' optimal outcome, HRQOL was uniformly reduced across all age groups.
authors.affiliation: High-Dependency Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Careggi, Lg. Brambilla 3, 50134, Florence, Italy, innocentif@aou-careggi.toscana.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Innocenti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Coppa
authors.forename: Beatrice
authors.initials: B
authors.lastname: Del Taglia
authors.forename: Federica
authors.initials: F
authors.lastname: Trausi
authors.forename: Alberto
authors.initials: A
authors.lastname: Conti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zanobetti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality*; D055815:Young Adult