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Geriatric Trauma and Emergency General Surgery

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Geriatrics for Specialists

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Abstract

Trauma and general surgery in the elderly has evolved from simple reports of postoperative complications to the impact of comorbidities on postoperative outcomes and recently to the novel concepts of frailty as a part of geriatric syndromes. Elderly patients differ significantly from their younger counterparts as they have a greater number of preexisting comorbidities, a greater risk of complications, and an increased rate of mortality. Even within elderly patients there are differences which are not due to age alone. These findings suggest that elderly patients are in need for a specific approach and management guidelines. Thus, surgeons have to first better identify and then adapt specific treatment strategies in order to decrease potential adverse effect and improve the care that they provide for their older patients.

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References

  1. Friese R, Wynne J, Joseph B, et al. Age and mortality after injury: is the association linear? Eur J Trauma Emerg Surg. 2014;40(5):567–72.

    Article  CAS  PubMed  Google Scholar 

  2. Rzepka SG, Malangoni MA, Rimm AA. Geriatric trauma hospitalization in the United States: a population-based study. J Clin Epidemiol. 2001;54(6):627–33.

    Article  CAS  PubMed  Google Scholar 

  3. Rhee P, Joseph B, Pandit V, et al. Increasing trauma deaths in the United States. Ann Surg. 2014;260(1):13–21.

    Article  PubMed  Google Scholar 

  4. Gillies D. Elderly trauma: they are different. Aust Crit Care. 1999;12(1):24–30.

    Article  CAS  PubMed  Google Scholar 

  5. Lord SR, Sherrington C, Menz HB, Close JC. Falls in older people: risk factors and strategies for prevention. Cambridge University Press; 2007. p. 3–26.

    Google Scholar 

  6. Joseph B, Pandit V, Khalil M, et al. Managing older adults with ground-level falls admitted to a trauma service: the effect of frailty. J Am Geriatr Soc. 2015;63(4):745–9.

    Article  PubMed  Google Scholar 

  7. Trauma ACoSCo. Advanced trauma life support student course manual. Chicago: American College of Surgeons; 2012.

    Google Scholar 

  8. Çevik Y, Doğan NÖ, Daş M, Karakayalı O, Delice O, Kavalcı C. Evaluation of geriatric patients with trauma scores after motor vehicle trauma. Am J Emerg Med. 2013;31(10):1453–6.

    Article  PubMed  Google Scholar 

  9. Sifrit KJ, Stutts J, Staplin L, Martell C. Intersection crashes among drivers in their 60s, 70s and 80s. Paper presented at: proceedings of the human factors and ergonomics society annual meeting, 2010.

    Google Scholar 

  10. Huang S-B, Chang W-H, Huang C-H, Tsai C-H. Management of elderly burn patients. Int J Gerontol. 2008;2(3):91–7.

    Article  Google Scholar 

  11. Jacobs DG, Plaisier BR, Barie PS, et al. Practice management guidelines for geriatric trauma: the EAST Practice Management Guidelines Work Group. J Trauma Acute Care Surg. 2003;54(2): 391–416.

    Article  Google Scholar 

  12. Evers BM, Townsend Jr C, Thompson J. Organ physiology of aging. Surg Clin North Am. 1994;74(1):23–39.

    Article  CAS  PubMed  Google Scholar 

  13. Stamatos C. Geriatric trauma patients: initial assessment and management of shock. J Trauma Nurs. 1993;1(2):45–54. quiz 55-46.

    Google Scholar 

  14. Scalea TM, Simon HM, Duncan AO, et al. Geriatric blunt multiple trauma: improved survival with early invasive monitoring. J Trauma Acute Care Surg. 1990;30(2):129–36.

    Article  CAS  Google Scholar 

  15. Morris JA, MacKenzie EJ, Edelstein SL. The effect of preexisting conditions on mortality in trauma patients. JAMA. 1990;263(14): 1942–6.

    Article  PubMed  Google Scholar 

  16. Muse DA. Conscious and deep sedation. In: The Clinical Practice of Emergency Medicine, 3rd ed, Harwood-Nuss, A, Wolfson, AB (Eds), Lippincott, Williams and Wilkins, Philadelphia 2001. p.1761.

    Google Scholar 

  17. Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury. 2012;43(1):8–17.

    Article  PubMed  Google Scholar 

  18. Kacey DJ, Perez-Tamayo A. Principles and practice of geriatric surgery. JAMA. 2012;307(18):1981.

    Article  CAS  Google Scholar 

  19. McGwin Jr G, MacLennan PA, Fife JB, Davis GG, Rue III LW. Preexisting conditions and mortality in older trauma patients. J Trauma Acute Care Surg. 2004;56(6):1291–6.

    Article  Google Scholar 

  20. Caterino JM, Valasek T, Werman HA. Identification of an age cutoff for increased mortality in patients with elderly trauma. Am J Emerg Med. 2010;28(2):151–8.

    Article  PubMed  Google Scholar 

  21. Barie PS, Hammond JS, Holevar MR, Sinclair KE, Scalea TM, Wahl W. Practice management guidelines for geriatric trauma. 2001.

    Google Scholar 

  22. Pandit V, Rhee P, Hashmi A, et al. Shock index predicts mortality in geriatric trauma patients: an analysis of the National Trauma Data Bank. J Trauma Acute Care Surg. 2014;76(4):1111–5.

    Article  PubMed  Google Scholar 

  23. Ellis G, Marshall T, Ritchie C. Comprehensive geriatric assessment in the emergency department. Clin Interv Aging. 2014;9: 2033.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jokar TO, Rhee PM, Zangbar B, et al. Redefining the association between old age and poor outcomes after trauma: the impact of the frailty syndrome. J Am Coll Surg. 2015;221(4):S83–4.

    Article  Google Scholar 

  25. Joseph B, Pandit V, Zangbar B, et al. Superiority of frailty over age in predicting outcomes among geriatric trauma patients: a prospective analysis. JAMA Surg. 2014;149(8):766–72.

    Article  PubMed  Google Scholar 

  26. Joseph B, Pandit V, Zangbar B, et al. Validating trauma-specific frailty index for geriatric trauma patients: a prospective analysis. J Am Coll Surg. 2014;219(1):10–7. e11.

    Article  PubMed  Google Scholar 

  27. Joseph B, Pandit V, Rhee P, et al. Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer? J Trauma Acute Care Surg. 2014;76(1):196–200.

    Article  PubMed  Google Scholar 

  28. Chang TT, Schecter WP. Injury in the elderly and end-of-life decisions. Surg Clin North Am. 2007;87(1):229–45. viii.

    Article  PubMed  Google Scholar 

  29. Kim PK, Kauder DR, Schwab CW. Acute care surgery and the elderly. In Britt LD, Trunkey DD, Feliciano DV, eds. Acute care surgery principles and practice. Springer; 2007. p. 187–93.

    Google Scholar 

  30. Levkoff SE, Cleary PD, Wetle T, Besdine RW. Illness behavior in the aged. J Am Geriatr Soc. 1988;36(7):622–9.

    Article  CAS  PubMed  Google Scholar 

  31. Watters JM, Blakslee JM, March RJ, Redmond ML. The influence of age on the severity of peritonitis. Can J Surg. 1996;39(2):142.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Bilimoria KY, Liu Y, Paruch JL, et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg. 2013;217(5):833–42.e831–3.

    Google Scholar 

  33. Faraklas I, Stoddard GJ, Neumayer LA, Cochran A. Development and validation of a necrotizing soft-tissue infection mortality risk calculator using NSQIP. J Am Coll Surg. 2013;217(1):153–60.e153; discussion 160-151.

    Google Scholar 

  34. Sadoum M, Zangbar B, Rhee PM, et al. NSQIP surgical risk calculator and frailty in emergency general surgery: a measure of surgical resilience. J Am Coll Surg. 2015;221(4):130.

    Google Scholar 

  35. Joseph B, Pandit V, Zangbar B, et al. Emergency general surgery in the elderly: too old or too frail? J Am Coll Surg. 2014;219(3):53–4.

    Google Scholar 

  36. Matrana MR, Margolin DA. Epidemiology and pathophysiology of diverticular disease. Clin Colon Rectal Surg. 2009;22(3): 141–6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Reisman Y, Ziv Y, Kravrovitc D, Negri M, Wolloch Y, Halevy A. Diverticulitis: the effect of age and location on the course of disease. Int J Colorectal Dis. 1999;14(4-5):250–4.

    Article  CAS  PubMed  Google Scholar 

  38. Thomson H, Busuttil A, Eastwood M, Smith A, Elton R. Submucosal collagen changes in the normal colon and in diverticular disease. Int J Colorectal Dis. 1987;2(4):208–13.

    Article  CAS  PubMed  Google Scholar 

  39. Stumpf M, Cao W, Klinge U, Klosterhalfen B, Kasperk R, Schumpelick V. Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease. Int J Colorectal Dis. 2001;16(5):271–5.

    Article  CAS  PubMed  Google Scholar 

  40. Clinch D, Banerjee AK, Ostick G. Absence of abdominal pain in elderly patients with peptic ulcer. Age Ageing. 1984;13(2): 120–3.

    Article  CAS  PubMed  Google Scholar 

  41. Ambrosetti P, Grossholz M, Becker C, Terrier F, Morel P. Computed tomography in acute left colonic diverticulitis. Br J Surg. 1997;84(4):532–4.

    Article  CAS  PubMed  Google Scholar 

  42. Cho KC, Morehouse HT, Alterman DD, Thornhill BA. Sigmoid diverticulitis: diagnostic role of CT—comparison with barium enema studies. Radiology. 1990;176(1):111–5.

    Article  CAS  PubMed  Google Scholar 

  43. Kellum JM, Sugerman HJ, Coppa GF, et al. Randomized, prospective comparison of cefoxitin and gentamicin-clindamycin in the treatment of acute colonic diverticulitis. Clin Ther. 1992;14(3): 376–84.

    CAS  PubMed  Google Scholar 

  44. Jacobs DO. Diverticulitis. N Engl J Med. 2007;357(20):2057–66.

    Article  CAS  PubMed  Google Scholar 

  45. Kärkkäinen JM, Lehtimäki TT, Manninen H, Paajanen H. Acute mesenteric ischemia is a more common cause than expected of acute abdomen in the elderly. J Gastrointest Surg. 2015;1–8.

    Google Scholar 

  46. Shih M-CP, Hagspiel KD. CTA and MRA in mesenteric ischemia: part 1, role in diagnosis and differential diagnosis. Am J Roentgenol. 2007;188(2):452–61.

    Article  Google Scholar 

  47. Ruotolo RA, Evans S. Mesenteric ischemia in the elderly. Clin Geriatr Med. 1999;15(3):527–57.

    CAS  PubMed  Google Scholar 

  48. Greenwald DA, Brandt LJ, Reinus JF. Ischemic bowel disease in the elderly. Gastroenterol Clin North Am. 2001;30(2):445–73.

    Article  CAS  PubMed  Google Scholar 

  49. Dupee RM. Case report: acute intestinal ischemia in the elderly. Ann Long Term Care. 2008;16(3):34.

    Google Scholar 

  50. Roth L, Greenberger NJ, Blumberg RS, Burakoff R. Current diagnosis & treatment: gastoenterology, hepatology, & endoscopy. 3rd ed. New York: McGraw Hill Companies Inc; 2009. ISSN 1946-3030. Can J Gastroenterol Hepatol. 2010;24(2):97.

    Google Scholar 

  51. Brunt L, Quasebarth M, Dunnegan D, Soper N. Outcomes analysis of laparoscopic cholecystectomy in the extremely elderly. Surg Endosc. 2001;15(7):700–5.

    Article  CAS  PubMed  Google Scholar 

  52. Riall TS, Zhang D, Townsend CM, Kuo Y-F, Goodwin JS. Failure to perform cholecystectomy for acute cholecystitis in elderly patients is associated with increased morbidity, mortality, and cost. J Am Coll Surg. 2010;210(5):668–77.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Wargo JA, Kahng KU. Benign disease of the gallbladder and pancreas. In: Rosenthal RA, Zenilman ME, Katlic MR, editors. Principles and practice of geriatric surgery. 2nd ed. New York: Springer; 2011. p. 361–76.

    Google Scholar 

  54. Krasman M, Gracie W, Strasius S. Biliary tract disease in the aged. Clin Geriatr Med. 1991;7(2):347–70.

    CAS  PubMed  Google Scholar 

  55. Einarsson K, Nilsell K, Leijd B, Angelin B. Influence of age on secretion of cholesterol and synthesis of bile acids by the liver. N Engl J Med. 1985;313(5):277–82.

    Article  CAS  PubMed  Google Scholar 

  56. Jansen PL, Strautnieks SS, Jacquemin E, et al. Hepatocanalicular bile salt export pump deficiency in patients with progressive familial intrahepatic cholestasis. Gastroenterology. 1999;117(6): 1370–9.

    Article  CAS  PubMed  Google Scholar 

  57. Poston GJ, Singh P, Maclellan DG, et al. Age-related changes in gallbladder contractility and gallbladder cholecystokinin receptor population in the guinea pig. Mech Ageing Dev. 1988; 46(1–3):225–36.

    Article  CAS  PubMed  Google Scholar 

  58. Parker LJ, Vukov LF, Wollan PC. Emergency department evaluation of geriatric patients with acute cholecystitis. Acad Emerg Med. 1997;4(1):51–5.

    Article  CAS  PubMed  Google Scholar 

  59. Cobden I, Venables C, Lendrum R, James O. Gallstones presenting as mental and physical debility in the elderly. Lancet. 1984;323(8385):1062–4.

    Article  Google Scholar 

  60. Morrow DJ, Thompson J, Wilson SE. Acute cholecystitis in the elderly: a surgical emergency. Arch Surg. 1978;113(10):1149–52.

    Article  CAS  PubMed  Google Scholar 

  61. De Dombal F. Acute abdominal pain in the elderly. J Clin Gastroenterol. 1994;19(4):331–5.

    Article  PubMed  Google Scholar 

  62. Hafif A, Gutman M, Kaplan O, Winkler E, Rozin R, Skornick Y. The management of acute cholecystitis in elderly patients. Am Surg. 1991;57(10):648–52.

    CAS  PubMed  Google Scholar 

  63. Lyon C, Clark DC. Diagnosis of acute abdominal pain in older patients. Am Fam Physician. 2006;74(9):1537–44.

    PubMed  Google Scholar 

  64. Hanau LH, Steigbigel NH. Acute (ascending) cholangitis. Infect Dis Clin North Am. 2000;14(3):521–46.

    Article  CAS  PubMed  Google Scholar 

  65. Siegel JH, Kasmin FE. Biliary tract diseases in the elderly: management and outcomes. Gut. 1997;41(4):433–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Glenn F. Acute cholecystitis. Surg Gynecol Obstet. 1976;143(1):56–60.

    CAS  PubMed  Google Scholar 

  67. Omari AH, Khammash MR, Qasaimeh GR, Shammari AK, Yaseen MK, Hammori SK. Acute appendicitis in the elderly: risk factors for perforation. World J Emerg Surg. 2014;9(1):6.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Freund H, Rubinstein E. Appendicitis in the aged. Is it really different? Am Surg. 1984;50(10):573–6.

    CAS  PubMed  Google Scholar 

  69. Paajanen H, Kettunen J, Kostiainen S. Emergency appendectomies in patients over 80 years. Am Surg. 1994;60(12):950–3.

    CAS  PubMed  Google Scholar 

  70. Yamini D, Vargas H, Bongard F, Klein S, Stamos MJ. Perforated appendicitis: is it truly a surgical urgency? Am Surg. 1998;64(10):970–5.

    CAS  PubMed  Google Scholar 

  71. Eldar S, Nash E, Sabo E, et al. Delay of surgery in acute appendicitis. Am J Surg. 1997;173(3):194–8.

    Article  CAS  PubMed  Google Scholar 

  72. Segev L, Keidar A, Schrier I, Rayman S, Wasserberg N, Sadot E. Acute appendicitis in the elderly in the twenty-first century. J Gastrointest Surg. 2015;19(4):730–5.

    Article  PubMed  Google Scholar 

  73. Sherlock DJ. Acute appendicitis in the over-sixty age group. Br J Surg. 1985;72(3):245–6.

    Article  CAS  PubMed  Google Scholar 

  74. Pooler BD, Lawrence EM, Pickhardt PJ. MDCT for suspected appendicitis in the elderly: diagnostic performance and patient outcome. Emerg Radiol. 2012;19(1):27–33.

    Article  PubMed  Google Scholar 

  75. Guller U, Jain N, Peterson ED, Muhlbaier LH, Eubanks S, Pietrobon R. Laparoscopic appendectomy in the elderly. Surgery. 2004;135(5):479–88.

    Article  PubMed  Google Scholar 

  76. Hansson J, Körner U, Khorram-Manesh A, Solberg A, Lundholm K. Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg. 2009;96(5):473–81.

    Article  CAS  PubMed  Google Scholar 

  77. Hui TT, Major KM, Avital I, Hiatt JR, Margulies DR. Outcome of elderly patients with appendicitis: effect of computed tomography and laparoscopy. Arch Surg. 2002;137(9):995–8; discussion 999–1000.

    Google Scholar 

  78. Lagoo-Deenadayalan SA, Newell MA, Pofahl WE. Common perioperative complications in older patients. In: Rosenthal RA, Zenilman ME, Katlic MR, editors. Principles and practice of geriatric surgery. 2nd ed. New York: Springer; 2011. p. 361–76.

    Google Scholar 

  79. Radtke F, Franck M, Hagemann L, Seeling M, Wernecke K, Spies C. Risk factors for inadequate emergence after anesthesia: emergence delirium and hypoactive emergence. Minerva Anestesiol. 2010;76(6):394–403.

    CAS  PubMed  Google Scholar 

  80. Young J, Inouye SK. Delirium in older people. BMJ. 2007;334(7598):842.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Ansaloni L, Catena F, Chattat R, et al. Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. Br J Surg. 2010;97(2):273–80.

    Article  CAS  PubMed  Google Scholar 

  82. Strøm C, Rasmussen L. Challenges in anaesthesia for elderly. Singapore Dent J. 2014;35:23–9.

    Article  Google Scholar 

  83. Beliveau MM, Multach M. Perioperative care for the elderly patient. Med Clin N Am. 2003;87(1):273–89.

    Article  PubMed  Google Scholar 

  84. Cunha BA. Urinary tract infections in males. Conns Current Therapy. 2003:733–5.

    Google Scholar 

  85. Feldman C. Pneumonia in the elderly. Med Clin N Am. 2001;85(6):1441–59.

    Article  CAS  PubMed  Google Scholar 

  86. Neumayer L, Hosokawa P, Itani K, El-Tamer M, Henderson WG, Khuri SF. Multivariable predictors of postoperative surgical site infection after general and vascular surgery: results from the patient safety in surgery study. J Am Coll Surg. 2007;204(6):1178–87.

    Article  PubMed  Google Scholar 

  87. Kirby JP, Mazuski JE. Prevention of surgical site infection. Surg Clin North Am. 2009;89(2):365–89.

    Article  PubMed  Google Scholar 

  88. Kaye KS, Anderson DJ, Sloane R, et al. The effect of surgical site infection on older operative patients. J Am Geriatr Soc. 2009;57(1):46–54.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Barie PS. Surgical site infections: epidemiology and prevention. Surg Infect (Larchmt). 2002;3(S1):s9–21.

    Article  Google Scholar 

  90. Dellinger EP, Hausmann SM, Bratzler DW, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg. 2005;190(1):9–15.

    Article  PubMed  Google Scholar 

  91. McGory ML, Maggard MA, Ko CY. A meta-analysis of perioperative beta blockade: what is the actual risk reduction? Surgery. 2005;138(2):171–9.

    Article  PubMed  Google Scholar 

  92. Auerbach AD, Goldman L. β-Blockers and reduction of cardiac events in noncardiac surgery: scientific review. JAMA. 2002;287(11):1435–44.

    CAS  PubMed  Google Scholar 

  93. Mehta RH, Rathore SS, Radford MJ, Wang Y, Wang Y, Krumholz HM. Acute myocardial infarction in the elderly: differences by age. J Am Coll Cardiol. 2001;38(3):736–41.

    Article  CAS  PubMed  Google Scholar 

  94. Ryder DL. The use of β-blockers to decrease adverse perioperative cardiac events. Dimens Crit Care Nurs. 2008;27(2):47–53.

    Article  PubMed  Google Scholar 

  95. Badner NH, Knill RL, Brown JE, Novick TV, Gelb A. Myocardial infarction after noncardiac surgery. Anesthesiology. 1998;88(3):572–8.

    Article  CAS  PubMed  Google Scholar 

  96. Loran DB, Hyde BR, Zwischenberger JB. Perioperative management of special populations: the geriatric patient. Surg Clin N Am. 2005;85(6):1259–66.

    Article  PubMed  Google Scholar 

  97. Amar D, Zhang H, Leung DH, Roistacher N, Kadish AH. Older age is the strongest predictor of postoperative atrial fibrillation. J Am Soc Anesthesiol. 2002;96(2):352–6.

    Article  Google Scholar 

  98. Ramsay JG. Cardiac management in the ICU. Chest J. 1999;115 Suppl 2:138S–44S.

    Google Scholar 

  99. Amar D. Prevention and management of perioperative arrhythmias in the thoracic surgical population. Anesthesiol Clin. 2008;26(2):325–35.

    Article  PubMed  Google Scholar 

  100. Ergina PL, Gold SL, Meakins JL. Perioperative care of the elderly patient. World J Surg. 1993;17(2):192–8.

    Article  CAS  PubMed  Google Scholar 

  101. Polanczyk CA, Marcantonio E, Goldman L, et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med. 2001;134(8):637–43.

    Article  CAS  PubMed  Google Scholar 

  102. McAlister FA, Bertsch K, Man J, Bradley J, Jacka M. Incidence of and risk factors for pulmonary complications after nonthoracic surgery. Am J Respir Crit Care Med. 2005;171(5):514–7.

    Article  PubMed  Google Scholar 

  103. Feinberg MJ, Knebl J, Tully J, Segall L. Aspiration and the elderly. Dysphagia. 1990;5(2):61–71.

    Article  CAS  PubMed  Google Scholar 

  104. Watters JM. Surgery in the elderly. Can J Surg. 2002;45(2):104–8.

    Google Scholar 

  105. Zafar SN, Obirieze A, Schneider EB, et al. Outcomes of trauma care at centers treating a higher proportion of older patients: the case for geriatric trauma centers. J Trauma Acute Care Surg. 2015;78(4):852–9.

    Article  PubMed  Google Scholar 

  106. G 60 Geriatric Trauma Program Trauma Newsletter Methodist Dallas Medical Center Adult Level I Trauma Center and Emergency Care. 2015. http://www.methodisthealthsystem.org/G60. Accessed 18 Nov 2015.

  107. Cohen HJ, Feussner JR, Weinberger M, et al. A controlled trial of inpatient and outpatient geriatric evaluation and management. N Engl J Med. 2002;346(12):905–12.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, The University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724, USA

    Bellal Joseph MD, FACS & Ahmed Hassan MD

  2. Department of Medicine, Arizona Center in Aging, University of Arizona College of Medicine, 1821 E. Elm Street, Tucson, AZ, 85719, USA

    Mindy J. Fain MD

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  1. Bellal Joseph MD, FACS
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  2. Ahmed Hassan MD
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  3. Mindy J. Fain MD
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Correspondence to Bellal Joseph MD, FACS .

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Editors and Affiliations

  1. Johns Hopkins University School of Medicine The Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA

    John R. Burton

  2. Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA

    Andrew G. Lee

  3. Division of Geriatrics and Gerontology Home Instead Center for Successful Aging Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA

    Jane F. Potter

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Joseph, B., Hassan, A., Fain, M.J. (2017). Geriatric Trauma and Emergency General Surgery. In: Burton, J., Lee, A., Potter, J. (eds) Geriatrics for Specialists. Springer, Cham. https://doi.org/10.1007/978-3-319-31831-8_12

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