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Better functional outcomes found in geriatric patients with high-energy vs low-energy trauma
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Geriatric patients experienced substantially worse function more than 1 year out from low-energy trauma injuries compared to geriatric patients with high-energy trauma injuries, according to published results.
Researchers found differences in physical function outcomes and return to independence between 216 geriatric patients with high-energy trauma injuries and 117 geriatric patients with low-energy trauma injuries. Results showed significantly higher Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scores in patients with high-energy trauma injuries compared with patients with low-energy trauma injuries. Researchers noted 67% of geriatric patients with high-energy trauma were able to ambulate outdoors without an assistive device vs. 28% of geriatric patients with low-energy trauma. Geriatric patients with high-energy and low-energy trauma were living independently 74% and 45% of the time, respectively, according to results. Low-energy mechanism injury was independently associated with a 13.2-point reduction in PROMIS physical function score, according to results of a multivariate linear regression analysis.
“Most high-energy trauma patients are able to stay relatively mobile without the use of an assistive device and are able to live independently, in contrast to low-energy fracture patients,” the authors wrote. “The present data furthermore suggest that data collected from low-energy patient cohorts are not applicable to high-energy geriatric trauma patients.” – by Casey Tingle
Disclosures: Shah reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Lisa K. Cannada, MD, FAAOS
With the aging population, we are all aware of hip fractures and their profound effect on one’s life. We know the increased morbidity and mortality in the first year, decreased independence and inability to return to former lifestyle. The geriatric trauma patient population is increasing. When we are speaking to these patients and their families, what kind of prognosis can we give them? Are these high-energy trauma patients in the same group as low-energy falls regarding outcomes?
This retrospective review was nicely done and provides us with useful information. What we learned is the elderly trauma patient is younger, females are the majority and the patient does have a significant increased likelihood of returning to independent living and ambulating without assistive devices. What’s more, despite having an average injury severity score of 16, their PROMIS physical function scores were higher. They are starting off as patients in better condition with a lower Charlson Comorbidity Index. A weakness is the mental effects of the trauma were not evaluated in this retrospective study. We learned a geriatric trauma patient does not have a death sentence and this information is useful for patients and their families.
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