Trauma in older people

Abstract

Globally, the population aged 60 or over is the fastest growing [1]. It is expected to increase by 45% globally by the middle of the century [1]. The increasing number of older individuals among the population is reflected by the increasing proportion of hospitalizations in this group [2]. Older patients have a higher absolute mortality rate following traumatic injury than younger patients [3]. Older age is associated with higher incidence rates of pre-existing comorbidities and chronic diseases [4]. The majority of older patients suffer typically from blunt trauma; falls from low height are the leading cause [3]. Despite existing triage tools, older people are often under-triaged [5, 6]. Delays in transfer of less-severely injured, older trauma patients to a regional trauma center can result in poor outcomes, including increased mortality [7]. Older adults with minor injuries have different injury patterns, higher acuity, and longer length of stay and are less often discharged home compared to younger adults [8]. The temporary loss of function of an extremity, combined with social isolation, often makes it impossible for the patient to continue an independent life. Furthermore, impaired cognition affects the capacity of older individuals to comprehend, recall, and adhere to treatment recommendations after an injury and puts them at risk for further negative health events [9].