Citation

Smith RM. Injury 2007; 38(12): 1401-1404.

Affiliation

Orthopaedic Trauma Service, Harvard Medical School, Massachusetts General Hospital, YAW 3600-3C, 55 Fruit Street, Boston, MA 02114, United States. msmith23@partners.org

Copyright

(Copyright © 2007, Elsevier Publishing)

DOI

10.1016/j.injury.2007.09.013

PMID

18045600

Abstract

It is believed that an uncontrolled or poorly coordinated immune reaction can be stimulated by major trauma and be responsible for the development of the multiple organ dysfunction syndrome (MODS). The elderly have a reduced ability to mount an effective immune reaction with deficiencies involving both humoral and cellular aspects of immunity that involve poor function of both the stimulatory and immuno-suppressive sides of the immune process. However, there is currently no hard evidence that the excess mortality after major trauma in the elderly is associated with an impaired or excessive immune response. It is possible that their poor resistance to infection is important and immune modulated but the dominant factor in the excess mortality in the elderly population is probably associated with their lack of physiological reserve to respond to a major physiological challenge.

Language: en