gms | German Medical Science

Objectives: We were interested in the differences in longer-term outcome of patients following major trauma with regard to age.

Methods: Prospective trauma center survey of survivors of trauma (>16 years) with a New Injury Severity Score (NISS)>8, investigating the influence of age on working capacity and several outcome scorings, such as the trauma medical outcomes study Short Form-36 (SF-36, physical (PCS) and mental (MCS) component), the Euro Quality of Life (EuroQoL), or the Trauma Outcome Profile (TOP) at least one year following injury. Mean+SD; chi-square; multivariate regression analysis (R2); p<0.05.

Result: 718 major trauma patients (53.4+19.4 years; NISS 18.4+9.2) participated in the study. Multivariate analysis showed only low associations of patient or trauma characteristics with longer-term outcome scorings, highest for the ISS of the extremities with the PCS (R2=0.08) or working capacity of employed patients (n=383; R2=0.04). For age, overall associations were even lower (best with the PCS, R2=0.04) or could not be revealed at all (TOP or MCS). Subgroup analysis with regard to decennia revealed this age effect to be mainly attributable to patients aged 80 or older, who presented with a significantly worse outcome compared to younger in all overall and physical component scores (p<0.001). In patients under 80 years an association of age was only found for the EuroQol (R2=0.01) and the PCS (R2=0.03).

Given the demonstrated small impact of age on the longer-term outcome of major trauma patients, at least up to an age of 80 years, resuscitation as well as rehabilitation strategies should be adapted accordingly.