Retrospective evaluation of factors affecting mortality in trauma patients aged 65 and over presenting to the emergency department

Aim: Trauma is the fifth leading cause of mortality in geriatric patients. This study aimed to retrospectively evaluate the factors influencing mortality in trauma patients aged 65 years and older who presented to the Emergency Department. Material and methods: 544 trauma patients aged 65 and over who were admitted to our center's Emergency Department and hospitalized were included in the study. Demographic data, comorbidities, injury types, vital signs at the time of admission, and laboratory results were recorded. Risk factors for in-hospital mortality were assessed using multivariate logistic regression analysis. Results: The mean age of the patients, 63.1% of whom were female, was 78.2±8.2 years. The most common mechanism of trauma was falls, accounting for 87.9% of cases. Lower extremity injuries were observed in 366 patients (67.3%), with femur fractures constituting the most frequent trauma site (59.9%). Ninety-one patients (16.7%) were admitted to the Intensive Care Unit. While 7.9% of patients developed complications during hospitalization, 24 patients (4.4%) died during their hospital stay. The median follow-up period of deceased patients was 10 days (1-42). In multivariate analysis, the Glasgow Coma Score (GCS) (OR: 0.363; 95% CI: 0.201- 0.653; p=0.001), thoracic trauma (OR: 12.738; 95% CI: 1.058-153.3; p=0.045), abdominal trauma (OR: 81.987; 95% CI: 4.092-1642; p=0.004), and the presence of hospitalization complications (OR: 243.966; 95% CI: 31.91-1864; p<0.001) were identified as independent prognostic factors for in-hospital mortality. Conclusion: In our study, GCS, thoracic trauma, abdominal trauma and the presence of hospitalization complications were determined as independent prognostic factors for in-hospital mortality. In conclusion, early identification of high-risk groups among elderly trauma patients, the implementation of strategies to prevent complications, and the optimization of emergency care processes are critical steps in reducing mortality rates