Emergency Medicine

Answer 1 Diminished physiologic reserve capacities of the heart and lungs contribute considerably to the unexpectedly high morbidity and mortality rates associated with geriatric trauma. Injured elderly patients lack the physiologic reserve capacities that youth provides and are less tolerant of delays in diagnosis or treatment. Employed as a scale to calculate anticipated outcome from trauma, the Injury Severity Score proves erratic when applied to older patients. Likewise, usual parameters like blood pressure measurements are also unreliable, as many older patients suffer from baseline hypertension. Regardless of advances in burn care management, the death rate for older burn patients still remains disproportionately high, with mortality rates in geriatric patients twice those observed in younger patients with similar total body surface area involvement. Although aging beyond 65 years increases susceptibility to death and disability, the prognosis for geriatric trauma patients is not as dismal as once projected, and over half of elderly trauma patients will resume independent living. Click here to return to the questions

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