Abstract

Background: The frequent exposure of older individuals to trauma has increased the importance of trauma management and the parameters affecting survival in the elderly. This study aimed to contribute to the literature on the parameters that should guide geriatric fluid management and to evaluate the predictive power of these parameters for mortality.

Methods: Demographic data, comorbidities, drug use history, type of pelvic trauma, shock follow-up parameters, operating conditions, complications, Acute Physiology and Chronic Health Evaluation II score and mortality status were retrospectively recorded in patients with pelvic trauma admitted to the emergency department from 2019-2022 and required intensive care follow-up.

Results: The study population was divided into two groups; the survival (n = 210) and the mortality group (n = 36). The mean age of the patients was 75.6 ± 7.1 years and 60.2% of the patients were male. Age and proportion of male patientswere significantly higher in the mortality group than in the survival group (median age 74 vs. 81 years and male sex 57.1% vs. 77.8%). The serum lactate level (p < 0.001), shock index (p < 0.001), age-related shock index (p < 0.00), trauma-specific frailty index (p < 0.001), and mean length of stay in intensive care unit (p < 0.001) were significantly higher in the mortality group than that for survival group. Multivariate logistic regression analyses revealed that cardiovascular diseases, beta blocker use, lactate levels, shock index, age shock index, trauma specific frailty index were associated with mortality.

Conclusion: Successful trauma resuscitation in geriatric patients should be managed by monitoring more reliable parameters such as shock index, age-related shock index, and serum lactate value, instead of relative values such as blood pressure and pulse.