title: Impact of age on the clinical outcomes of major trauma.
abstract: OBJECTIVE
  In view of demographic changes over the past few decades, the average age of trauma patients is progressively increasing. We therefore aimed to summarize the specific characteristics of geriatric trauma and to identify potential fields for further research to improve the care of elderly trauma patients.
  
  
  METHODS
  Review of the literature.
  
  
  RESULTS
  Due to the diverse risk factors (e.g., pre-existing conditions, limited physiological reserve), geriatric patients are prone to developing severe complications, even after less severe trauma. Yet, age is not considered as the only predictor of worse outcomes, and it should not be considered the only criterion for limiting care in those patients. It is crucial that age-specific treatment guidelines are developed to optimize the outcomes for senior trauma patients. Based on the current literature, these guidelines should emphasize the importance of field triage directly to a trauma center, along with the activation of the trauma team. Furthermore, early intensive monitoring, aggressive resuscitation, and time of surgical intervention are of upmost importance to reduce mortality.
  
  
  CONCLUSIONS
  The impact of several factors [age, premedical conditions (PMC), decreased physiological reserves, and impaired immune function] on the post-traumatic course of elderly trauma patients needs to be clarified in future experimental and clinical studies for the early identification of geriatric high-risk patients and for the development of age-adapted therapeutic strategies.
authors.affiliation: Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. fhildebrand@ukaachen.de.|Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University, Aachen, Germany. fhildebrand@ukaachen.de.
authors.forename: F
authors.initials: F
authors.lastname: Hildebrand
authors.affiliation: Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
authors.forename: H-C
authors.initials: HC
authors.lastname: Pape
authors.affiliation: Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.|Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University, Aachen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Horst
authors.affiliation: Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.|Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University, Aachen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Andruszkow
authors.affiliation: Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Kobbe
authors.affiliation: Department of Intensive Care Medicine, Aachen University, Aachen, Germany.
authors.forename: T-P
authors.initials: TP
authors.lastname: Simon
authors.affiliation: Department of Intensive Care Medicine, Aachen University, Aachen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Marx
authors.affiliation: Department of Intensive Care Medicine, Aachen University, Aachen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Schürholz
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D002985:Clinical Protocols; D015897:Comorbidity; D055416:Evidence-Based Emergency Medicine; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D009104:Multiple Trauma / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D012151:Resuscitation / Q000379:methods; D012307:Risk Factors; D014218:Triage / Q000379:methods
keywords: Geriatric trauma; Multiple trauma; Outcome; Pre-existing medical conditions