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Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare?
World J Surg. 2022 03; 46(3):582-590.WJ

Abstract

BACKGROUND

Little is known about the injury profile of older persons from low-and-middle-income countries, such as South Africa, where violence is prevalent. This study aimed to identify common mechanisms of injury (MOI), severity, complications, and outcomes in elderly patients admitted to a referral trauma centre in Cape Town.

METHODS

A retrospective review was performed of all patients ≥60 years presenting at Tygerberg hospital trauma centre over an eight-month period. Descriptive statistics were computed for all variables of interest, and the relationship between the MOI, injury severity score (ISS), complications, and outcomes were assessed.

RESULTS

Of the total 7,635 trauma cases admitted, patients ≥60 years accounted for 4% (n = 275). The most frequent MOI was low falls (58%). Of these 11% of injuries were intentionally inflicted. Among them 35% of the patients experienced complications. The ISS was positively associated with the number of complications (p < 0.01). The mortality rate was 6.5%. An ISS of ≥10 was associated with increased mortality (p < 0.01). The number of complications was positively associated with mortality (p < 0.01).

CONCLUSIONS

In contrast to high-income countries (HICs), the cohort of elderly patients admitted to the trauma centre made up a relatively small portion of the total admissions. Compared to HICs, intentionally inflicted injuries and preventable MOI were common in our sample, underscoring the importance of addressing causative factors. Notably, the ISS was strongly associated with the number of complications and an ISS ≥10 was associated with mortality, highlighting the utility of the ISS in identifying elderly trauma patients most at risk of negative outcomes.

Authors+Show Affiliations

Faculty of Medicine & Health Science, Stellenbosch University, Francie van Zijl Drive, Cape Town, South Africa. breedtshade@gmail.com.Division of Surgery, Stellenbosch University & Tygerberg Hospital, Francie van Zijl Drive, Cape Town, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34994839

Citation

Breedt, Danyca Shadé, and Elmin Steyn. "Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare?" World Journal of Surgery, vol. 46, no. 3, 2022, pp. 582-590.
Breedt DS, Steyn E. Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare? World J Surg. 2022;46(3):582-590.
Breedt, D. S., & Steyn, E. (2022). Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare? World Journal of Surgery, 46(3), 582-590. https://doi.org/10.1007/s00268-021-06416-6
Breedt DS, Steyn E. Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare. World J Surg. 2022;46(3):582-590. PubMed PMID: 34994839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geriatric Trauma in a High-Volume Trauma Centre in Cape Town: How Do We Compare? AU - Breedt,Danyca Shadé, AU - Steyn,Elmin, Y1 - 2022/01/07/ PY - 2021/11/23/accepted PY - 2022/1/8/pubmed PY - 2022/1/8/medline PY - 2022/1/7/entrez SP - 582 EP - 590 JF - World journal of surgery JO - World J Surg VL - 46 IS - 3 N2 - BACKGROUND: Little is known about the injury profile of older persons from low-and-middle-income countries, such as South Africa, where violence is prevalent. This study aimed to identify common mechanisms of injury (MOI), severity, complications, and outcomes in elderly patients admitted to a referral trauma centre in Cape Town. METHODS: A retrospective review was performed of all patients ≥60 years presenting at Tygerberg hospital trauma centre over an eight-month period. Descriptive statistics were computed for all variables of interest, and the relationship between the MOI, injury severity score (ISS), complications, and outcomes were assessed. RESULTS: Of the total 7,635 trauma cases admitted, patients ≥60 years accounted for 4% (n = 275). The most frequent MOI was low falls (58%). Of these 11% of injuries were intentionally inflicted. Among them 35% of the patients experienced complications. The ISS was positively associated with the number of complications (p < 0.01). The mortality rate was 6.5%. An ISS of ≥10 was associated with increased mortality (p < 0.01). The number of complications was positively associated with mortality (p < 0.01). CONCLUSIONS: In contrast to high-income countries (HICs), the cohort of elderly patients admitted to the trauma centre made up a relatively small portion of the total admissions. Compared to HICs, intentionally inflicted injuries and preventable MOI were common in our sample, underscoring the importance of addressing causative factors. Notably, the ISS was strongly associated with the number of complications and an ISS ≥10 was associated with mortality, highlighting the utility of the ISS in identifying elderly trauma patients most at risk of negative outcomes. SN - 1432-2323 UR - https://www.unboundmedicine.com/medline/citation/34994839/Geriatric_Trauma_in_a_High_Volume_Trauma_Centre_in_Cape_Town:_How_Do_We_Compare L2 - https://dx.doi.org/10.1007/s00268-021-06416-6 DB - PRIME DP - Unbound Medicine ER -