Article
Lung failure after thoracic trauma in the elderly – a retrospective analysis from the German TraumaRegister
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Authors
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Jan Tilmann Vollrath
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Uniklinik Frankfurt am Main, Frankfurt am Main, Germany
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Ingo Marzi
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Uniklinik Frankfurt am Main, Frankfurt am Main, Germany
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Rolf Lefering
- Institut für Forschung in der Operativen Medizin (IFOM), Köln, Germany
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Philipp Störmann
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Uniklinik Frankfurt am Main, Frankfurt am Main, Germany
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DGU TraumaRegister, Sektion NIS der DGU, Berlin, Germany
| Published: | October 26, 2021 |
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Outline
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Objective: In Germany and developed countries worldwide the number of higher aged patients is increasing. Pulmonary complications are common in multiple traumatized patients with chest injury. We assessed whether geriatric patients develop lung failure following multiple trauma with concomitant thoracic trauma more often than younger patients.
Methods: A retrospective analysis of patients suffering from blunt thoracic trauma and a Maximum Abbreviated Injury Scale (MAIS) of 3 or greater to any body region which were registered in the German TraumaRegister DGU® (TR-DGU) between 2009 and 2018 was performed. Patients without thoracic trauma, penetrating or unknown mechanism of injury, younger than 18 years of age, early transfer to another hospital (< 24 hours), no Intensive Care Unit (ICU)-treatment and no organ failure documentation were excluded. Patients were categorized into five age groups (18-54y, 55-64y, 65-74y, 75-84y,>85y). TR-DGU project ID: 2019-056. Data provision was carried out by TraumaRegister DGU®. Evaluation and interpretation are in the author's responsibility and haven't yet accomplished the review process of TraumaRegister DGU®.
Results and Conclusion: A total of 43,289 patients were included, thereof 9,238 (21.3%) developed lung failure during their clinical stay. With growing age, an increasing rate of posttraumatic lung failure was observed. While lung failure markedly increased length of hospital stay, duration of mechanical ventilation and ICU-length of stay independent of patient's age, differences between younger and older patients with lung failure in regard to these parameters were clinically comparable. In addition, the development of respiratory failure showed a distinct increase in mortality with higher age from 16.9% (18-54 years) to 67.2% (> 85 years).
Development of lung failure after multiple trauma with concomitant thoracic trauma markedly increases hospital length of stay, ICU-length of stay and duration of intubation in patients regardless of age. However, the highest effects of lung failure, particularly in terms of mortality, were seen in the oldest patients.
