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.