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Impact of age on the clinical outcomes of major trauma

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Abstract

Purpose

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Orthopaedic Trauma, Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

    F. Hildebrand, H.-C. Pape, K. Horst, H. Andruszkow & P. Kobbe

  2. Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University, Aachen, Germany

    F. Hildebrand, K. Horst & H. Andruszkow

  3. Department of Intensive Care Medicine, Aachen University, Aachen, Germany

    T.-P. Simon, G. Marx & T. Schürholz

Authors
  1. F. Hildebrand
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  2. H.-C. Pape
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  3. K. Horst
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  4. H. Andruszkow
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  5. P. Kobbe
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  7. G. Marx
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  8. T. Schürholz
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Corresponding author

Correspondence to F. Hildebrand.

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The presented review followed the ethical requirements in accordance to the guidelines of the revised UN Declaration of Helsinki in 1975 and its latest amendment in 1996 (42nd general meeting). This review article did not involve human participants and/or animals directly, and an informed consent was not required.

Conflict of interest

Frank Hildebrand, Hans-Christoph Pape, Klemens Horst, Hagen Andruszkow, Philipp Kobbe, Tim-Philipp Simon, Gernot Marx, and Tobias Schürholz declare no conflicts of interest.

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Hildebrand, F., Pape, HC., Horst, K. et al. Impact of age on the clinical outcomes of major trauma. Eur J Trauma Emerg Surg 42, 317–332 (2016). https://doi.org/10.1007/s00068-015-0557-1

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  • DOI: https://doi.org/10.1007/s00068-015-0557-1

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