Assessment of factors affecting the outcome of elderly blunt trauma in Emergency Department

ABSTRACT

The purpose of this study is to evaluate factors affecting the outcome of elderly blunt trauma in emergency department. The study was conducted on 100 elderly patients age above 60 years with   blunt trauma admitted to Emergency Department of Alexandria Main University Hospital. Primary survey, secondary survey and radiological investigations were done for these patients. Evaluation of patient injury severity by injury severity score (ISS) .Patient outcome as regard death, discharge, transfer and complications due to trauma or treatment were reported. Falling down was the most common mechanism of injury in our study occurred in 49% of cases followed by RTA in 27 % of cases but RTA was the most common cause of injury leading to death. 93% of cases had systolic blood pressure ≥ 90 mmHg who considered hemodynamically stable on admission and 7% of  cases had systolic blood pressure <90 mmHg  who considered hemodynamically unstable on admission. Systolic blood pressure on admission was directly proportional with the outcome (p<0.001). GCS of our patients in this study ranged between 4 and 15 with a mean± SD of 13.98 ± 2.72 and median of 15. There were 88 % of cases with GCS more than 12 .4% of cases with GCS between 9 and 12 while 8% of cases had a GCS less than or equal to 8, the mortality is inversely proportion to GCS (p<0.001) ISS in our study ranged between 1.0 - 35.0 with mean ± SD of 8.54 ± 9.70 and median of 5, ISS was directly proportional with the outcome and higher ISS was associated with higher mortality. As regard past illness 22 patients had no past illness while the most common past illness was hypertension which presented in 31 patients and the least common past illness was cerebrovascular stroke and psychosis each present in 5 % of cases .Regarding lines of treatment, 55 patients had conservative treatment and 8 patients were unfit for surgery while surgical interventions were done for 37 patients. According to complications in our study, 76 patients (76%) had no complications while 24 patients (24%) had complications where the most common complication was   pneumonia which presented in 7 patients (7%) followed by DKA and DIC which presented in 5 patients (5%) in each of them and the most common complication which associated with the highest ratio for mortality after geriatric trauma was DIC.

Key words : outcome, elderly, blunt trauma

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