The role of cardiac morbidity in short- and long-term mortality in injured older patients who survive initial resuscitation

Am J Surg. 2003 Feb;185(2):131-4. doi: 10.1016/s0002-9610(02)01208-4.

Abstract

Background: Elderly patients are an increasingly larger group of injured trauma care patients. Comorbidities influence outcome. Little is known of short- and long-term mortality in the elderly who survive initial resuscitation.

Methods: Short- and long-term mortality was retrospectively analyzed in 363 consecutively injured patients (Injury severity score >15) surviving more than 3 days after admission to a level 1 trauma center (including 197 patients >60 years). Cardiac morbidity was the focus.

Results: Survival to hospital discharge was similar comparing older patients with the entire group. Mortality increased incrementally with age. In older patients, cardiac morbidity was observed in 28% (fatal in 7); 2-year mortality was 36% (older group) and 60% (patients sustaining cardiac complications). Most elderly (80%) were discharged to long-term care.

Conclusions: Elderly who survive initial resuscitation are as likely to survive to discharge as younger patients, but long-term survival is significantly lower as age increases. Cardiac morbidity is associated with higher long-term mortality. Most elderly are discharged to long-term care.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Heart Diseases / mortality*
  • Humans
  • Long-Term Care
  • Middle Aged
  • Morbidity
  • Patient Discharge
  • Resuscitation / mortality*
  • Retrospective Studies
  • Survival Analysis
  • Trauma Severity Indices
  • Treatment Outcome
  • Wounds and Injuries / mortality*