Trauma

Trauma is a major cause of morbidity and mortality among older persons. Although fewer than 20 percent of trauma patients are 65 years of age or older, older patients represent 28 percent of trauma deaths.2122 They are more likely to have significant complications and prolonged hospitalizations because of their decreased functional reserve.21 Falls are the most common mechanism of injury for older persons, followed by motor vehicle crashes and pedestrian accidents. Regardless of injury severity or mechanism of injury, mortality increases for patients at 50 years of age and continues to increase with increasing age. The major challenge for emergency physicians who treat older patients who have multisystem trauma is that the standard physiologic indices, such as blood pressure and pulse, often remain within normal limits until the patient deteriorates acutely. Occult shock must be strongly suspected in all older patients who experience significant trauma. Early hemodynamic monitoring of older trauma patients can detect occult shock early in the course and improve the chance of survival. 2122 (See Chap...245, "Geriatric Trauma.")

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