gms | German Medical Science

Objectives: The burden of geriatric trauma patients continues to rise due to the increasing life expectancy. The aim of this study was to determine epidemiological differences between geriatric trauma victims and their younger counterparts.

Methods: Data on 114.169 adult trauma patients from the Trauma Registry of the German Trauma Society was studied. All adult patients that were admitted since 2013 and had complete data sets were included. Patients were grouped based on differences in age. Group 1 consisted of geriatric patients (55 years and older) and patients aged 18-55 years were included in group 2. Additionally, the geriatric group was further divided in subgroups based on age . Epidemiology and outcome were compared between groups.

Results: A total of 55.404 geriatric patients and 58.765 adult individuals were included. A male pre-dominance was observed in both study groups. However, this effect was more prominent in the younger patient group than in the elderly (respectively 77.4% vs. 63.7% male patients). Older age was further associated with altered injury mechanisms: frequencies of traffic accidents and falls out of greater heights decreased, whereas the occurrence of falls out of small heights increased up to 76.8% of cases in patients > 90 years of age. Higher ASA-scores were encountered in the geriatric comparing to the young patients group. Decreased utilization of total body CT-imaging at admission was observed in older patients (50.7% vs. 80.7% in young patients). Mortality rates increased with age: the overall mortality in young trauma patients was 7.0%, and a mortality rate of 40.2% was found in patients > 90 years of age.

Conclusion: This study shows that geriatric trauma patients are more often injured due to low-impact trauma than younger patients. Furthermore, diagnostics as well as outcome differ between groups and mortality rates are noticeably higher in the older patients. Given the aging society in Western Europe upcoming studies should focus on optimizing trauma care and implementing prognostic scoring systems for the group of vulnerable geriatric patients.