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Comparative analysis of trauma characteristics between elderly and younger trauma patients

OBJECTIVE: Assess the characteristics of trauma in the elderly by comparison to a group of younger trauma patients. METHODS: Trauma protocols from June 10, 2008 to March 9, 2009 were evaluated including all trauma patients above 13 years of age admitted in the emergency room. Data on trauma mechanism, concomitant diseases, vital signs upon admission, diagnosed injuries, trauma indexes, exams and treatment was collected. Patients above 60 years of age. were included in the elderly group (group I). Data was compared between this group and the younger patients (group II), using the Student's t, chi square and Fisher exact tests, considering p<0.05 as significant. RESULTS: Two thousand and seventy five victims of trauma were included (77.1% male), 211 (10.2%) in group I. The most frequent trauma mechanisms in the elderly were falls (from their own height) (41%) and pedestrian struck (28%). Concomitant diseases were more frequent in group I, including systemic arterial hypertension and diabetes mellitus. In group I, the most frequent lesions were located at extremities in 106 patients (50.2%). Fractures were present in 18% of the elderly. In comparison to younger trauma patients, the elderly had significantly higher head AIS (0.75 + 1.17 vs 0.54 + 1.04) (p=0.014) and lower thoracic (0.15 + 0.62 vs 0.26 + 0.86) (p=0.018) and abdominal (0.05 + 0.43 vs 0.21 + 0.82) (p<0.001) AIS. Severe injuries (AIS > 3) in the head were more frequently observed in group I (11.4% vs 7%) (p=0,023). Some injuries were more frequent in group I: subdural hematomas (2.8% vs 0.8%) (p=0.008), subarachnoid hemorrhage (3.8% vs 1.3%) (p=0.005) and cerebral contusions (5.2% vs 2.3%) (p=0.015). CONCLUSION: In comparison to younger trauma patients, the elderly group was characterized by a higher frequency of falls from their own height, , concomitant diseases and severe injuries in the head, mainly subdural hematomas, cerebral contusions and subarachnoid hemorrhage.

Multiple trauma; Geriatrics; Accidental falls; Hospital mortality


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