Skip to main content
SpringerLink
Log in

Trauma in Older People

  • Chapter
  • First Online:
Book cover Geriatric Emergency Medicine

  • 1517 Accesses

Abstract

Globally, the population aged 60 or over is the fastest growing [1]. It is expected to increase by 45% globally by the middle of the century [1]. The increasing number of older individuals among the population is reflected by the increasing proportion of hospitalizations in this group [2]. Older patients have a higher absolute mortality rate following traumatic injury than younger patients [3]. Older age is associated with higher incidence rates of pre-existing comorbidities and chronic diseases [4]. The majority of older patients suffer typically from blunt trauma; falls from low height are the leading cause [3]. Despite existing triage tools, older people are often under-triaged [5, 6]. Delays in transfer of less-severely injured, older trauma patients to a regional trauma center can result in poor outcomes, including increased mortality [7]. Older adults with minor injuries have different injury patterns, higher acuity, and longer length of stay and are less often discharged home compared to younger adults [8]. The temporary loss of function of an extremity, combined with social isolation, often makes it impossible for the patient to continue an independent life. Furthermore, impaired cognition affects the capacity of older individuals to comprehend, recall, and adhere to treatment recommendations after an injury and puts them at risk for further negative health events [9].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. World population prospects the 2012 revision, United Nations, New York, 2013

    Google Scholar 

  2. Hill AD, Pinto R, Nathens AB, Fowler RA (2014) Age-related trends in severe injury hospitalization in Canda. J Trauma Acute Care Surg 77(4):608–613

    Article  Google Scholar 

  3. O’Neill S, Brady RR, Kerssens JJ, Parks RW (2012) Mortality associated with traumatic injuries in the elderly: a population based study. Arch Gerontol 54:e426–e430

    Article  Google Scholar 

  4. Rau C, Lin T, Wu S, Yang J, Hsu S, Cho T, Hsieh C (2014) Geriatric hospitalizations in fall-related injuries. Scand J Trauma Resusc Emerg Med 22:63

    Article  Google Scholar 

  5. Lehmann R, Beekley A, Casey L et al (2009) The impact of advanced age on trauma triage decisions and outcomes: a statewide analysis. Am J Surg 197:571–574

    Article  Google Scholar 

  6. Grossmann FF, Zumbrunn T, Frauchiger A, Delport K, Bingisser R, Nickel C (2012) At risk of undertriage? Testing the performance and accuracy of the emergency severity index in older emergency department patients. Ann Emerg Med 60(3):317–325

    Article  Google Scholar 

  7. Fischer PE, Colavita PD, Fleming GP, Huynh TT, Christmas AB, Sing RF (2014) Delays in transfer of elderly less-injured trauma patients can have deadly consequences. Am Surg 80(11):1132–1135

    PubMed  Google Scholar 

  8. Lutze M, Fry M, Gallagher R (2014) Minor injuries in older adults have different characteristics, injury patterns, and outcomes when compared with younger adults: an emergency department correlation study. Int Emerg Nurs

    Google Scholar 

  9. Ouellet MC, Sirois MJ, Beaulieu-Bonneau S, Morin J, Perry J, Daoust R, Wilding L, Provencher V, Camden S, Allain-Boulé N, Emond M (2014) Is cognitive function a concern in independent elderly adults discharged home from the emergency Department in Canada after a minor injury? J Am Geriatr Soc 62(11):2130–2135

    Article  Google Scholar 

  10. Kanonidou Z, Karystianou G (2007) Anesthesia for the elderly. Hippokratia 11(4):175–177

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Georgescu V, Tudorache O, Strambu V (2014) Traumatic cardiac arrest in the emergency department – overview upon primary causes. J Med Life 7(2):287–290

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Ley EJ, Clond MA, Srour MK, Barnajian M, Mirocha J, Margulies DR, Salim A (2011) Emergency department crystalloid resuscitation of 1.5 L or more is associated with increased mortality in elderly and nonelderly trauma patients. J Trauma 70(2):398–400

    Article  Google Scholar 

  13. Leenen M, Scholz A, Lefering R, Flohé S (2014) Limited volume resuscitation in hypotensive elderly multiple trauma is safe and prevents early clinical dilutive coagulopathy – a matched pair analyses from Trauma Registry DGU. Injury 45:59–63

    Article  Google Scholar 

  14. Mitra B, Olaussen A, Cameron PA, O’Donohoe T, Fitzgerald M (2014) Massive blood transfusions post trauma in the elderly compared to younger patients. Injury 45(9):1296–1300

    Article  Google Scholar 

  15. Bar-Or D, Salottolo KM, Orlando A, Mains CW, Bourg P, Offner PJ (2013) Association between a geriatric trauma resuscitation protocol using venous lactate measurements and early trauma surgeon involvement and mortality risk. J Am Geriatr Soc 61(8):1358–1364

    Article  Google Scholar 

  16. Salottolo KM, Mains CW, Offner PJ, Bourg PW, Bar-Or D (2013) Retrospective analysis of geriatric trauma patients: venous lactate is a better predictor of mortality than traditional vital signs. Scand J Trauma Resusc Emerg Med 21:7

    Article  Google Scholar 

  17. Aviv J (1997) Effects of aging on sensitivity of the pharyngeal and supraglottic area. Am J Med 103(5A):74S–76S

    Article  CAS  Google Scholar 

  18. Marik P (2001) Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 334(9):665–671

    Article  Google Scholar 

  19. Sell D, Lane MA, Johnson WA, Masoro EJ, Mock OB, Reiser KM, Fogarty JF, Cutler RG, Ingram DK, Roth GS, Monnier VM (1996) Longevity and the genetic determination of collagen glycoxidation kinetics in mammalian senescence. Proc Natl Acad Sci U S A 93(1):485–490

    Article  CAS  Google Scholar 

  20. Zaugg M, Lucchinetti E (2000) Respiratory function in the elderly. Anesthesiol Clin North Am 18(1):47–58

    Article  CAS  Google Scholar 

  21. Bergman SA, Coletti D (2006) Perioperative management of the geriatric patient. Part I: respiratory system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:e1–e6

    Article  Google Scholar 

  22. Imamura T, Brown CA, Ofuchi H, Yamagami H, Branch J, Hagiwara Y, Brown DFM, Hasegawa K (2013) Emergency airway management in geriatric and younger patients: analysis of a multicenter prospective observational study. Am J Emerg Med 31(1):190–196

    Article  Google Scholar 

  23. Agnew AM, Schafman M, Moorhouse K, White SE, Kang YS (2015) The effect of age on the structural properties of human ribs. J Mech Behav Biomed Mater 41:302–314

    Article  Google Scholar 

  24. Alrayashi W (2014) Anesthesia for the geriatric trauma patient. In: Anesthesia for trauma. Springer + Business Media, New York

    Google Scholar 

  25. Arden JR, Holley FO, Stanski DR (1986) Increased sensitivity to etomidate in the elderly: initial distribution versus altered brain response. Anesthesiology 65(1):9–27

    Article  Google Scholar 

  26. Homer TD, Stanski DR (1985) The effect of increasing age on thiopental disposition and anesthetic requirement. Anesthesiology 62(6):714–724

    Article  CAS  Google Scholar 

  27. Reves JG, Fragen RJ, Vinik HR, Greenblatt DJ (1985) Midazolam: pharmacology and uses. Anesthesiology 62(3):310–324

    Article  CAS  Google Scholar 

  28. Rao MH, Venkatraman A, Mallleswari R (2011) Comparison of intubating conditions between rocuronium with priming and without priming: randomized and double-blind study. Indian J Anaesth 55(5):494–498

    Article  Google Scholar 

  29. Aziz L, Jahangir SM, Choudhury SNS, Rahman K, Ohta Y, Hirakawa M (1997) The effect of priming with vecuronium and rocuronium on young and elderly patients. Anesth Analg 85:663–666

    Article  CAS  Google Scholar 

  30. American Association of Neuroscience Nurses (2007) AANN clinical practice guideline series, Retrieved March 10th, 2015, from www.aann.org/pdf/cpg/aannneuroassessmentolderadult.pdf

  31. Love S (2006) Neuropathology of aging. In: Pathy MSJ, Sinclair AJ, Morley JE (eds) Principles and practice of geriatric medicine, 4th edn. Wiley, Hoboken, pp 69–84

    Google Scholar 

  32. Keck BJ, Lakoski JM (2001) Neurochemistry of receptor dynamics in the aging brain. In: Hof PR, Mobbs CV (eds) Functional neurobiology of aging. Academic Press, San Diego, pp 21–29

    Chapter  Google Scholar 

  33. Agins AP, Kelly JF (2006) Assessment, pharmacotherapy and clinical management of depression, dementia and delirium in geriatric patients [computer DVD]. American Association of Neuroscience Nurses, Glenview

    Google Scholar 

  34. Meyer JS, Kawamura J, Terayama Y (1994) Cerebral blood flow and metabolism with normal and abnormal aging. In: Albert ML, Knoefel JF (eds) Clinical neurology og aging, 2nd edn. Oxford University Press, New York, pp 214–234

    Google Scholar 

  35. Mobbs C (2006) Aging of the brain. In: Pathy MSJ, Sinclair AJ, Morley JE (eds) Principles and practice of geriatric medicine, 4th edn. Wiley, Hoboken, pp 59–67

    Google Scholar 

  36. Gilmore R (1995) Evoked potentials in the elderly. J Clin Neurophysiol 12(2):132–138

    Article  CAS  Google Scholar 

  37. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB (2015) Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 131(4):e29–e322

    PubMed  Google Scholar 

  38. Kehoe A, Rennie S, Smith JE (2014) Glascow coma scale is unreliable for the prediction of severe head injury in elderly trauma patients. Emerg Med J:1–3

    Google Scholar 

  39. Chen X, Mao G, Leng SX (2014) Frailty syndrome: an overview. Clin Interv Aging 19(9):433–441

    Google Scholar 

  40. Shamliyan T, Talley KM, Ramakrishnan R, Kane RL (2013) Association of frailty with survival: a systematic literature review. Ageing Res Rev 12(2):719–736

    Article  Google Scholar 

  41. Toussaint N, de Roon M, van Campen JP, Kremer S, Boesveldt S (2015) Loss of olfactory function and nutritional status in vital older adults and geriatric patients. Chem Senses 40(3):197–203

    Article  CAS  Google Scholar 

  42. Bell JJ, Bauer JD, Capra S, Pulle RC (2014) Concurrent and predictive evaluation of malnutrition diagnostic measures in hip fracture inpatients: a diagnostic accuracy study. Eur J Clin Nutr 68(3):358–362

    Article  CAS  Google Scholar 

  43. Gosch M, Druml T, Nicholas JA, Hoffmann-Weltin Y, Roth T, Zegg M, Blauth M, Kammerlander C (2015) Fragility non-hip fracture patients are at risk. Arch Orthop Trauma Surg 135(1):69–77

    Article  CAS  Google Scholar 

  44. Cline CMJ, Björck-Linné AK, Israelsson BYA, Willenheimer RB, Erhardt LR (1999) Non-compliance and knowledge of prescribed medication in elderly patients with heart failure. Eur J Heart Fail 1(2):145–149

    Article  CAS  Google Scholar 

  45. Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, Taddei GC, Casati M, Franchi C, Djade CD, Nobili A (2014) Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs Aging 31(4):283–289

    Article  CAS  Google Scholar 

  46. Chester JG, Rudolph JL (2011) Vital signs in older patients: age-related changes. J Am Med Dir Assoc 12(5):337–343

    Article  Google Scholar 

  47. Dritto PH, Danks JH, Smucker WD, Bookwala J, Coppola KM, Dresser R, Fagerlin A, Gready RM, Houts RM, Lockhart LK, Zyzanski S (2001) Advance directives as acts of communication: a randomized controlled trial. Arch Intern Med 161(3):421–430

    Article  Google Scholar 

  48. Shapiro SP (2015) Do advance directives direct? J Health Polit Policy Law

    Google Scholar 

  49. Shimoda K, Maeda T, Tado M, Yoshino A, Katayama Y, Bullock MR (2014) Outcome and surgical management for geriatric traumatic brain injury: analysis of 888 cases registered in the Japan Neurotrauma Data Bank. World Neurosurg 82(6):1300–1306

    Article  Google Scholar 

  50. Brazinova A, Mauritz W, Majdan M, Rehorcikova V, Leitgeb J (2014) Fatal traumatic brain injury in older adults in Austria 1980 – 2012: an analysis of 33 years. Age Ageing 44(3):502–506. pii: afu 194

    Article  Google Scholar 

  51. Hamden K, Agresti D, Jeanmonod R, Woods D, Reiter M, Jeanmonod D (2014) Characteristics of elderly fall patients with baseline mental status: high-risk features for intracranial injury. Am J Emerg Med 32(8):890–894

    Article  Google Scholar 

  52. Borkar SA, Sinha S, Agrawal D, Satyarthee GD, Gupta D, Mahapatra AK (2011) Severe head injury in the elderly: risk factor assessment and outcome analysis in a series of 100 consecutive patients at a level 1 trauma centre. Indian J Neurotrauma 8(2):77–82

    Article  Google Scholar 

  53. Wang H, Coppola M, Robinson RD, Scribner JT, Vithalani V, de Moor CE, Gandhi RR, Burton M, Delaney KA (2013) Geriatric trauma patients with cervical spine fractures due to ground level fall: five years experience in a level one trauma center. J Clin Med Res 5(2):75–83

    PubMed  PubMed Central  Google Scholar 

  54. Westerveld LA, Verlaan JJ, Oner FC (2009) Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. Eur Spine J 18(2):145–156

    Article  CAS  Google Scholar 

  55. Deghan N, de Mestral C, McKee MD, Schemtisch EH, Nathens A (2014) Flail chest injuries: a review of outcomes and treatment practices from the national trauma data bank. J Trauma Acute Care Surg 76(2):462–468

    Article  Google Scholar 

  56. Bulger EM, Edwards T, Klotz P, Jurkovich GJ (2004) Epidural analgesia improves outcome after multiple rib fractures. Surgery 136(2):426–430

    Article  Google Scholar 

  57. Yeh DD, Kutcher ME, Knudson MM, Tang JF (2012) Epidural analgesia for blunt thoracic injury – which patients benefit most? Injury 43(10):1667–1671

    Article  Google Scholar 

  58. Carrier FM, Turgeon AF, Nicole PC, Trépanier CA, Fergusson DA, Thauvette D, Lessard MR (2009) Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth 56(3):230–242

    Article  Google Scholar 

  59. De Jong MB, Kokke MC, Hietbrink F, Leenen LPH (2014) Surgical management of rib fractures: strategies and literature review. Scand J Surg 103(2):120–125

    Article  Google Scholar 

  60. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, Lee G, Bailey M, Fitzgerald M (2013) Prospective randomized controlled trial of operative rib fixation in traumatic flail chest

    Google Scholar 

  61. Slobogean GP, MacPherson CA, Sun T, Pelletier ME, Hameed M (2013) Surgical fixation vs nonoperative management of flail chest: a meta-analysis. J Am Coll Surg 216(2):302–311

    Article  Google Scholar 

  62. Clancy K, Velopulos C, Bilaniuk JW, Collier B, Crowley W, Kurek S, Lui F, Nayduch D, Sangosanya A, Tucker B, Haut ER (2012) Screening for blunt cardiac injury: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg 73(5 Suppl 4):301–306

    Article  Google Scholar 

  63. Velmahos GC, Karaiskakis M, Salim A, Toutouzas KG, Murray J, Asensio J, Demetriades D (2003) Normal electrocardiography and serum troponin I levels preclude the presence of clinically significant blunt cardiac injury. J Trauma 54(1):45–50

    Article  Google Scholar 

  64. Naughton PA, Park MS, Morasch MD, Rodriguez HE, Garcia-Toca M, Wang CE, Eskandari MK (2012) Emergent repair of acute thoracic aortic catastrophes. Arch Surg 147(3):243–249

    Article  Google Scholar 

  65. Cheng D, Martin J, Shennib H, Dunning J, Muneretto C, Schueler S, Von Segesser L, Sergeant P, Turina M (2010) Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease. J Am Coll Cardiol 55(10):986–1001

    Article  Google Scholar 

  66. Schattner A, Mavor E, Adi M (2014) Unsuspected serious abdominal trauma after falls among community-dwelling older adults. QJM 107(8):649–653

    Article  CAS  Google Scholar 

  67. Strassen NA, Bhullar I, Cheng JD, Crandall M, Friese R, Guillamondegui O, Jawa R, Maung A, Rohs TJ Jr, Sangosanya A, Schuster K, Seamon M, Tchorz KM, Zarzuar BL, Kerwin A (2012) Nonoperative management of blunt hepatic injury: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg 73(5 Suppl 4):288–293

    Article  Google Scholar 

  68. Strassen NA, Bhullar I, Cheng JD, Crandall M, Friese R, Guillamondegui OD, Jawa RS, Maung AA, Rohs TJ Jr, Sangosanya A, Schuster KM, Seamon MJ, Tchorz KM, Zarzuar BL, Kerwin AJ (2012) Selective nonoperative management of blunt splenic injury: an eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surg 73(5 Suppl 4):294–300

    Article  Google Scholar 

  69. Bellal J, Pandit V, Harrison C, Lubin D, Kulvatunyou N, Zangbar B, Tang A, O’Keeffe T, Green DJ, Gries L, Friese RS, Rhee P (2015) Early thromboembolic prophylaxis in patients with blunt solid abdominal injuries undergoing nonoperative management: is it safe? Am J Surg 209(1):194–198

    Article  Google Scholar 

  70. Sullivan MP, Baldwin KD, Donegan DJ, Mehta S, Ahn J (2014) Geriatric fractures about the hip: divergent patterns in the proximal femur, acetabulum, and pelvis. Orthopedics 37(3):151–157

    Article  Google Scholar 

  71. Clement ND, Court-Brown CM (2014) Elderly pelvic fractures: the incidence is increasing and patient demographics can be used to predict the outcome. Eur J Orthop Surg Traumatol 24(8):1431–1437

    Article  Google Scholar 

  72. Studer P, Suhm N, Zappe B, Bless N, Jakob M (2013) Pubic rami fractures in the elderly – a neglected injury? Swiss Med Wkly 143:w13859

    PubMed  Google Scholar 

  73. Courtney PM, Taylor R, Scolaro J, Donegan D, Mehta S (2014) Displaced inferior ramus fractures as a marker of posterior pelvic injury. Arch Orthop Trauma Surg 134(7):935–939

    Article  Google Scholar 

  74. Nüchtern JV, Hartel MJ, Henes FO, Groth M, Jauch SY, Haegele J, Briem D, Hoffmann M, Lehmann W, Rueger JM, Grossterlinden LG (2015) Significance of clinical examination, CT and MRI scan in the diagnosis of posterior pelvic ring fractures. Injury 46(2):315–319

    Article  Google Scholar 

  75. Chen PH, Hsu WH, Li YY, Huang TW, Huang TJ, Peng KT (2013) Outcome analysis of unstable posterior ring injury of the pelvis: comparison between percutaneous iliosacral screw fixation and conservative treatment. Biomed J 36(6):289–294

    Article  Google Scholar 

  76. Hill BW, Switzer JA, Cole PA (2012) Management of high-energy acetabular fractures in the elderly individuals: a current review. Geriatr Orthop Surg Rehabil 3(3):95–106

    Article  Google Scholar 

  77. Gary JL, Paryavi E, Gibbons SD, Weaver MJ, Morgan JH, Ryan SP, Starr AJ, O’Toole RV (2015) The effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study on 454 patients. J Orthop Trauma 29(4):202–208

    Article  Google Scholar 

  78. Herscovici D, Lindvall E, Bolhofner B, Scaduto JM (2010) The combined hip procedure: open reduction internal fixation combined with total hip arthroplasty for the management of acetabular fractures in the elderly. J Orthop Trauma 24(5):291–296

    Article  Google Scholar 

  79. Jakob M, Droeser R, Zobrist R, Messmer P, Regazzoni P (2006) A less invasive anterior intrapelvic approach for the treatment of acetabular fractures and pelvic ring injuries. J Trauma 60(6):1364–1370

    Article  CAS  Google Scholar 

  80. O’Toole RV, Hui E, Chandra A, Nascone JW (2014) How often does open reduction and internal fixation of geriatric acetabular fractures lead to hip arthroplasty? J Orthop Trauma 28(3):148–153

    Article  Google Scholar 

  81. Rau CS, Lin TS, Wu SC, Yang J, Hsu SY, Cho TY, Hsieh CH (2014) Geriatric hospitalizations in fall-related injuries. Scand J Trauma Resusc Emerg Med 22(1):63

    Article  Google Scholar 

  82. Lindahl H, Malchau H, Herberts P, Garellick G (2005) Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish national hip arthroplasty register. J Arthroplast 20(7):857–865

    Article  Google Scholar 

  83. Court-Brown CM, Biant LC, Clement ND, Bugler KE, Duckworth AD, McQueen MM (2015) Open fractures in the elderly. The importance of skin ageing. Injury 46(2):189–194

    Article  Google Scholar 

  84. Toole WP, Elliott M, Hankins D, Rosenbaum C, Harris A, Perkins C (2014) Are low-energy open ankle fractures in the elderly the new geriatric hip fracture? J Foot Ankle Surg 54(2):203–206

    Article  Google Scholar 

  85. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383

    Article  CAS  Google Scholar 

  86. Parker MJ, Palmer CR (1993) A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br 75(5):797–798

    Article  CAS  Google Scholar 

  87. Maxwell MJ, Moran CG, Moppett IK (2008) Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth 101(4):511–517

    Article  CAS  Google Scholar 

  88. Penrod JD, Litke A, Hawkes WG, Magaziner J, Koval KJ, Doucette JT, Silberzweig SB, Siu AL (2007) Heterogeneity in hip fracture patients: age, functional status, and comorbidity. J Am Geriatr Soc 55(3):407–413

    Article  Google Scholar 

  89. Hopley C, Stengel D, Ekkernkamp A, Wich M (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ 340:c2332

    Article  Google Scholar 

  90. Sabesan VJ, Valikodath T, Childs A, Sharma VK (2015) Economic and social impact of upper extremity fragility fractures in elderly patients. Aging Clin Exp Res 27(4):539–546

    Article  Google Scholar 

  91. Fu T, Xia C, Li Z, Wu H (2014) Surgical versus conservative treatment for displaced proximal humeral fractures in elderly patients: a meta-analysis. Int J Clin Exp Med 7(12):4607–4615

    PubMed  PubMed Central  Google Scholar 

  92. Chalmers PN, Slikker W, Mall NA, Gupta AK, Rahman Z, Enriquez D, Nicholson GP (2014) Reverse total shoulder arthroplasty for acute proximal humerla fracture: comparison to open reduction-internal fixation and hemiarthroplasty. J Shoulder Elb Surg 23(2):197–204

    Article  Google Scholar 

  93. Salzmann GM, Strohm P, Südkamp NP, Morawski M, Spranger A, Ekkernkamp A, Dietz S, Rothenbach E, Roomens PM, Müller-Pongratz F, Siebert N, Kirschner M, Wagner M, Siebenlist S, Stöckle U, Kallasch E, Ockert B, Kessler M, Mutschler W, Schulz A, Borninger N, Wilde E, Schlottau S, Schreiber T, Grützner PA, Veiel T, Sarkar MR, Obermaier S, Ramsayer B, Scheiderer B, Scola A, Buhl K, Erni B, Büchler MW, Napp M, Gondert M, Bachmann S, Probst C, Gaulke R, Krettek C (2014) The treatment of displaced intra-articular distal radius fractures in elderly patients. Dtsch Arztebl Int 111(46):779–787

    Google Scholar 

  94. Gielen E, Verschueren S, O’Neill TW, Pye SR, O’Connell MD, Lee DM, Ravindrarajah R, Claessens F, Laurent M, Milisen K, Tournoy J, Dejaeger M, Wu FC, Vanderschueren D, Boonen S (2012) Muskuloskeletal frailty: a geriatric syndrome at the core of fracture occurrence in older age. Calcif Tissue Int 91(3):161–177

    Article  CAS  Google Scholar 

  95. Harper CM, Fitzpatrick SK, Zurakowski D, Rozental TD (2014) Distal radius fractures in older men: a missed opportunity? J Bone Joint Surg Am 96(21):1820–1827

    Article  Google Scholar 

  96. Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR (2014) Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the dubbo osteoporosis epidemiology study. J Bone Miner Res

    Google Scholar 

  97. Dong X (2012) Advancing the field of elder abuse: future directions and policy implications. J Am Geriatr Soc 60(11):2151–2156

    Article  Google Scholar 

  98. Bonnie RJ, Wallace RB (eds) 2003 Elder mistreatment: abuse, neglect, and exploitation in an aging America. Panel to review risk and prevalence of elder abuse and neglect. Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education. The National Academics Press, Washington

    Google Scholar 

  99. Rinker AG Jr (2009) Recognition and perception of elder abuse by prehospital and hospital-based care providers. Arch Gerontol Geriatr 48(1):110–115

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, CH-4032, Basel, Switzerland

    Nicolas Bless

  2. Department of Traumatology, University Hospital Basel, Petersgraben 2, CH-4032, Basel, Switzerland

    Nicolas Bless

Authors
  1. Nicolas Bless
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Bless .

Editor information

Editors and Affiliations

  1. Emergency Department, University Hospital Basel, Basel, Switzerland

    Christian Nickel

  2. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Abdelouahab Bellou

  3. Department of Health Sciences, University of Leicester, Leicester, UK

    Simon Conroy

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bless, N. (2018). Trauma in Older People. In: Nickel, C., Bellou, A., Conroy, S. (eds) Geriatric Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-19318-2_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19318-2_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19317-5

  • Online ISBN: 978-3-319-19318-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation