Eden L, Kühn A, Gilbert F, Meffert RH, Lefering R. Dtsch. Arztebl. Int. 2019; 116(27-28): 479-485.
Affiliation
Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius Maximilians University Würzburg; Department of Orthopedics and Trauma Surgery, Robert-Bosch-Krankenhaus Stuttgart; Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU).
BACKGROUND: Motorcycle accidents account for a large fraction of the patients with polytrauma treated in German hospitals. Clinical experience indicates that an in- creasing number of older motorcyclists are having accidents. We studied whether such individuals are subject to higher mortality and longer hospital stays.
METHODS: We retrospectively evaluated data from the Traumaregister DGU® (TR- DGU) concerning all patients (n = 13 850) who were registered in the TR-DGU as having sustained trauma in a motorcycle accident from 2002 to 2015 and who had an Injury Severity Score (ISS) greater than 8. The patients were divided into four age groups for further study.
RESULTS: Despite a nearly identical severity of anatomical injury according to the ISS, persons sustaining trauma in motorcycle accidents who were over 65 years of age (n = 892) needed longer and more intensive treatment than their younger counter- parts. They were invasively ventilated for a longer time (+ 1.2 days), kept for a longer time on the intensive care unit (+ 1.7 days), and stayed in the hospital three days longer. These older persons injured in motorcycle accidents had a disproportionate mortality in comparison to other polytrauma patients and a significantly elevated mor- tality in comparison to their younger counterparts-15.8%, compared to 7.2% among patients aged 45 to 64. Older trauma patients are more likely than younger ones to develop lethal complications in the later course of their hospitalization, while younger trauma patients who die generally do so as a direct result of the traumatic injury.
CONCLUSION: Patients over age 65 who sustain trauma in motorcycle accidents have a higher mortality, a longer duration of ventilation, and longer stays in the intensive care unit and in the hospital overall than their younger counterparts. These patients present a special challenge to the treating medical team.