Effects of co-morbid disease and drug consumption on trauma patients 65 years of age and older: a university emergency department experience

BACKGROUND: The objective of this study was to evaluate the causes and demographics of trauma patients 65 years of age and older, and also the effects of co-morbidities and drug use on trauma. METHODS: This study was performed in Medicine Faculty of Yeditepe University Hospital Department of Emergency Medicine Outpatients Clinic between January 2005 - February 2006. Ninety-one trauma patients (48 males [52.7%], 43 females [47.3%]; mean age 73±5.42; range 65 to 92 years) 65 years of age and older were included into the study. Age, gender, trauma causes, injury types, co-morbidities, drug consumption and injury severity scores were recorded onto the study form.
RESULTS: Fifty-seven (62.6%) patients were admitted to the emergency department because of low-energy fall, 13 patients (14.3%) for high-energy falls, 6 patients (6.6%) for low-energy motor vehicle crush, and 14 patients (15.4%) for high-energy motor vehicle crush. Hypertension was significantly more frequent in falls than the other trauma mechanisms (p=0.003). There was a higher rate of femur fracture in low-energy falls than the others (p=0.026). However, the rate of vertebral fracture was higher in high-energy falls (p=0.037). Soft tissue injuries were seen most often in low-energy motor vehicle crush injuries (p=0.01) while rib fractures were seen most frequently in high-energy motor vehicle crush injury (p<0.01). CONCLUSION: Acute or chronic disease and drug side effects may facilitate the exposure of elderly people to trauma. Drug consumption, co-morbid diseases and trauma causes should be taken into consideration during the evaluation of elderly trauma patients.

Altmýþ beþ yaþ ve üstü travmalý hastalarda yandaþ hastalýk ve ilaç kullanýmýnýn travma üzerine etkileri: Üniversite acil servis deneyimi

AMAÇ: Travma nedeniyle acil servise baþvuran 65 yaþ ve üstü bireylerin travma nedenleri, travma sonucu ortaya çýkan bulgular, yandaþ hastalýklarýnýn ve ilaç kullanýmýnýn travma etyolojisi üzerine olan etkisi araþtýrýldý. GEREÇ-YÖNTEM: Bu çalýþma Yeditepe Üniversitesi Hastanesi acil servisinde Ocak 2005 ile Þubat 2006 tarihleri arasýnda gerçekleþtirildi. Çalýþmaya, travma nedeniyle acil servise getirilen 65 yaþ ve üstü 91 olgu (48 erkek [%52,7], 43 kadýn [%47,3]; ortalama yaþ 73±5,42; daðýlým 65-92) dahil edildi. Olgularýn yaþlarý, cinsiyetleri, baþvuru nedenleri, yaralanma tipleri, yandaþ hastalýklarý, ilaç kullanýmlarý ve Yaralanma Þiddeti Ölçeði incelendi. BULGULAR: Hastalarýn 57’si (%62,6) düþük enerjili düþme, 13’ü (%14,3) yüksek enerjili düþme, 6’sý (%6,6) düþük enerjili araç kazasý ve 14’ü (%15,4) yüksek enerjili araç kazasý nedeniyle baþvurdu. Düþme nedeniyle baþvuran hastalarda, hipertansiyon, düþme dýþý nedenlere göre anlamlý olarak daha sýk rastlandý (p=0,003). Düþük enerjili düþmelerde femur kýrýðý daha sýk gözlendi (p=0,026). Yüksek enerjili düþmelerle vertebra kýrýðý arasýnda anlamlý bir iliþki saptandý (p=0,037). Düþük enerjili motorlu araç kazalarýnda yumuþak doku travmasý anlamlý olarak daha yüksek idi (p=0,01). Yüksek enerjili motorlu araç kazalarý ile kot kýrýðý arasýnda anlamlý olarak iliþki vardý (p<0,001). SONUÇ: Akut ya da kronik hastalýklar ve ilaçlarýn etkileri yaþlý bireylerin yaralanma riskini arttýrmaktadýr. Bu nedenlerden dolayý tüm yaþlý travma hastalarý deðerlendirilirken ilaç kullanýmý, yandaþ hastalýk öyküsü dikkatle sorgulanmalý ve travmaya neden olan faktörler de göz önünde bulundurulmalýdýr.