FACTORS EFFECTING MORTALITY AND MORBIDITY IN THE TRAUMA IN THE ELDERLY

Aim: To evaluate the factors effecting morbidity and mortality in geriatric trauma patients. Method: 318 elderly patients with multiple injuries were evaluated to analyse the effects of injury mechanism, preexisting disease, Injury Severity Score (ISS), Revised Trauma Score (RTS) on outcome. Results: Age was not found to be a factor on mortality and complication, while it increased disability. Falls were the mechanism mostly associated with the mortality. We found that preexisting chronic illnesses other than cardiovascular diseases were not significantly related to mortality, complication and hospital stay. Complication increased disability, ICU stay and hospital stay. Disability was found in 57.9% of the 133 patients followed. ISS and RTS were predictors of survival and ISS was also a good predictor of disability. The mortality increased with blood transfusion and mechanical ventilation. Conclusion: ISS, RTS, injury mechanism (falls), shock at the admission, head injury, transfusion and mechanical ventilation significantly predict mortality. Age, complication and ISS are related to disability. Complication is the only factor related to a prolonged hospital stay.

GERÝATRÝK TRAVMADA MORTALÝTE VE MORBÝDÝTEYE ETKÝ EDEN FAKTÖRLER

Amaç: Bu çalýþmanýn amacý geriatrik travma olgularýnda mortalite ve morbiditeye etki eden faktörlerin ortaya konmasýdýr. Metod: 318yaþlý çoklu yaralanmalý olgu; yaralanma mekanizmasýnýn, altta yatan hastalýðýn, Yaralanma Aðýrlýðý Skorunun (ISS), Düzeltilmiþ Travma Skorunun (RTS) sonuca etkisi bakýmýndan incelenmiþtir. Bulgular: Yaþýn mortalite ve komplikasyon oranýna etki etmediði, ancak sekeli etkilediði belirlenmiþtir. Ölüme en çok neden olan yaralanma mekanizmasýnýn düþme olduðu saptanmýþtýr. Kardiyovasküler hastalýk dýþýndaki altta yatan hastalýklarýn varlýðý mortalite, komplikasyon oranýný ve hastanede kalýþ sürelerini etkilemediði saptanmýþtýr. Komplikasyon geliþiminin sekeli, yoðun bakýmda ve hastanede kalýþ süresini artýrdýðý gözlenmiþtir. Takip edilebilen 133 hastanýn %57.9'unda sekel bulunmuþtur. ISS ve RTS mortaliteyi belirlemede önemli bulunurken; BS ayný zamanda sekeli belirlemek açýsýndan da önemli bulunmuþtur. Mekanik ventilasyon ve kan transfüzyonu yapýlanlarda mortalitenin arttýðý gözlenmiþtir.Sonuç: ISS, RTS, yaralanma mekanizmasý (düþmeler), baþvuru sýrasýnda þok varlýðý, kafa travmasý, transfüzyon ve mekanik ventilasyon mortaliteyi artýrmaktadýr. Ýleri yaþ, komplikasyon geliþimi ve ISS ise sekel riskini belirlemede önemli bulunurken, hastanede kalýþ süresi uzunluðu yalnýzca komplikasyon geliþimi ile iliþkili bulunmuþtur.