title: Mortality after trauma laparotomy in geriatric patients.
abstract: BACKGROUND
  Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy.
  
  
  METHODS
  A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006-2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality.
  
  
  RESULTS
  A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2-4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy.
  
  
  CONCLUSIONS
  Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies.
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona. Electronic address: bjoseph@surgery.arizona.edu.
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Bardiya
authors.initials: B
authors.lastname: Zangbar
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Ansab
authors.initials: A
authors.lastname: Haider
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Mazhar
authors.initials: M
authors.lastname: Khalil
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Gary
authors.initials: G
authors.lastname: Vercruysse
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Lynn
authors.initials: L
authors.lastname: Gries
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications / Q000401:mortality / Q000601:surgery*
keywords: Age; Complications; Geriatric trauma; Lactate; Mortality; Trauma laparotomy