title: Geriatric trauma.
abstract: OBJECTIVE
  The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly.
  
  
  RESULTS
  Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement.
  
  
  CONCLUSIONS
  Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.
authors.affiliation: Center for Translational Injury Research, Department of Surgery, UT Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Sasha D
authors.initials: SD
authors.lastname: Adams
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
mesh_terms: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001778:Blood Coagulation Disorders / Q000503:physiopathology; D003266:Continuity of Patient Care / Q000458:organization & administration*; D006259:Craniocerebral Trauma; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D010166:Palliative Care / Q000458:organization & administration; D018570:Risk Assessment; D013727:Terminal Care / Q000458:organization & administration; D014218:Triage / Q000379:methods; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D000925:Anticoagulants