Llompart-Pou JA, Pérez-Bárcena J, Chico-Fernández M, Sánchez-Casado M, Raurich JM. Severe trauma in the geriatric population. World J Crit Care Med 2017; 6(2): 99-106 [PMID: 28529911 DOI: 10.5492/wjccm.v6.i2.99]
Corresponding Author of This Article
Juan Antonio Llompart-Pou, MD, PhD, Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa, 79, 07120 Palma de Mallorca, Spain. juanantonio.llompart@ssib.es
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. May 4, 2017; 6(2): 99-106 Published online May 4, 2017. doi: 10.5492/wjccm.v6.i2.99
Severe trauma in the geriatric population
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Joan Maria Raurich, Servei de Medicina Intensiva, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
Mario Chico-Fernández, Servicio de Medicina Intensiva, UCI Trauma y Emergencias, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
Marcelino Sánchez-Casado, Servicio de Medicina Intensiva, Hospital Virgen de la Salud, 45071 Toledo, Spain
Author contributions: Llompart-Pou JA wrote the manuscript; Pérez-Bárcena J, Chico-Fernández M, Sánchez-Casado M and Raurich JM made literature search, provided intellectual contribution and made critical reviews; all authors gave final approval.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Juan Antonio Llompart-Pou, MD, PhD, Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa, 79, 07120 Palma de Mallorca, Spain. juanantonio.llompart@ssib.es
Telephone: +34-87-1205974 Fax: +34-87-1909721
Received: January 16, 2017 Peer-review started: January 18, 2017 First decision: February 15, 2017 Revised: March 3, 2017 Accepted: March 16, 2017 Article in press: March 17, 2017 Published online: May 4, 2017
Abstract
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury. Under-triage is common in this population. Evaluation of frailty could be helpful to solve this issue. Appropriate triaging and early aggressive management with correction of coagulopathy can improve outcome. Limitation of care and palliative measures must be considered in cases with a clear likelihood of poor prognosis.
Core tip: Geriatric trauma constitutes an increasing problem. These patients have a limited response to injury. Falls constitute the most relevant mechanism of injury. Specific problems in this population include frailty, under-triage and the combination of traumatic brain injury and use of anticoagulants. Early aggressive treatment and palliative care in cases with a clear likelihood of poor prognosis must be considered.
