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The Elderly Patient

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Penetrating Trauma

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Abstract

The geriatric population is the fastest growing age group today, and geriatric trauma accounts for a significant proportion of admissions to trauma centers. Due to functional changes with age, preexisting diseases, and pre-injury medications, geriatric trauma patients have limited physiological reserves and, therefore, require much more aggressive evaluation and treatment than their younger counterparts. A low threshold for field triage directly to a trauma center is warranted in elderly trauma patients. The primary and secondary survey follows ATLS guidelines; however, age-related conditions impact patient evaluation. The treatment algorithms for penetrating trauma in the elderly are no different. In any bleeding elderly patient, consider damage control interventions early. Selective nonoperative management of penetrating solid organ injuries, applied in many young trauma victims, is more likely to fail in older patients and, in general, should be reserved for low-grade injuries. When managed successfully, a significant number of elderly patients sustaining penetrating trauma will be able to return to levels of reasonable function and thus justify aggressive management.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Bern University Hospital, Inselspital, Bern, Switzerland

    Thomas Lustenberger

  2. Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, Los Angeles, CA, USA

    Kenji Inaba

Authors
  1. Thomas Lustenberger
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  2. Kenji Inaba
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Correspondence to Kenji Inaba .

Editor information

Editors and Affiliations

  1. University of the Witwatersrand Medical School, Johannesburg, South Africa

    Elias Degiannis

  2. Saarland University, Medical School, Homburg / Saar, Germany

    Dietrich Doll

  3. Massachusetts General Hospital, Harvard University Medical School, Boston, MA, USA

    George C. Velmahos

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Lustenberger, T., Inaba, K. (2023). The Elderly Patient. In: Degiannis, E., Doll, D., Velmahos, G.C. (eds) Penetrating Trauma. Springer, Cham. https://doi.org/10.1007/978-3-031-47006-6_83

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  • DOI: https://doi.org/10.1007/978-3-031-47006-6_83

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-47005-9

  • Online ISBN: 978-3-031-47006-6

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