Factors affecting mortalitiy and morbidity in geriatric patients with chest trauma admitted to emergency department

The changes in the physiological response to trauma in old age, together with the increase in comorbidities and the decrease in physiological reserve, are the main reasons that increase geriatric mortality. Elderly patients constitute an important and difficult case group for healthcare professionals due to the increase in hospital admissions and high mortality. Studies on the diagnosis and treatment process of trauma patients generally focus on the young population and there is not enough research on injury mechanisms, scoring systems, resuscitation variables, advanced treatment steps and many other subjects in geriatric trauma patients. This situation has begun to be understood by the scientific community and studies on this subject have started to gain momentum. The aim of this study is to determine the variables that can provide early mortality estimation in geriatric trauma patients. A retrospective study was conducted on patients over the age of 65 with chest trauma, regardless of gender, who applied to the emergency department between 01.01.2015 and 01.10.2020. 226 patients were evaluated. Patients whose files could not be accessed and with incomplete information, patients under 65 years of age, patients without burns and electric shocks, patients without chest trauma, and patients with arrest were excluded from the study.Hemogram, biochemistry, blood gas, coagulation parameters and chest tomography, other imaging, patient file and follow-up forms were evaluated through the hospital management information system. The data obtained from the study were evaluated using the SPSS (Statistical Package for the Social Sciences) 18.0 package program and and a p value of <0.05 was considered statistically significant. In this study, we determined that GKS, RTS, ISS, TRISS, GTOS scores affect mortality. We also observed that mortality increased in the presence of concomitant system injury. We observed that mortality can occur even in falling, which is a simple trauma compared to young patients. And we found that mortality increased in the presence of abnormal blood parameters such as Ca, hb, hct, lactate. With the development of living standards, the elderly population is increasing in our country, and in parallel, the number of geriatric trauma patients who apply to the emergency department is increasing. Geriatric trauma patients need a multidisciplinary approach and treatment in the emergency department due to their high mortality and morbidity. With a versatile and multidisciplinary approach, the length of stay in the hospital is shortened and mortality is reduced. Thus, the economic burden, loss of time and labor is prevented. Keywords; Emergency department, geriatric chest trauma, mortality