Prognosis of major trauma in patients older than 85 years admitted to the ICU, a registry-based study.
Vincent Legros, Benjamin Picard, Jean Pasqueron, Lukshe Kanagaratnam, Delphine Garrigue, Emmanuel Rozenberg, Paul Mandrillon, Julien Pottecher, Pierre-Antoine Seube-Remy, Thomas Vettese, Jean-Luc Hanouz, Pierre Gosset, Benjamin Popoff, Mathieu Willig, Benjamin Cohen, Fanny Bounes, Paer Selim Abback, Traumabase Group
Author Information
Vincent Legros: Anesthesiology, Critical Care and Perioperative Medicine, Reims University Hospital, Hopital Maison Blanche, CHU de Reims, 45 Rue Cognacq Jay, 51092, Reims, Cedex, France. vlegros@chu-reims.fr.
Benjamin Picard: Department of Anesthesiology and Critical Care, Beaujon University Hospital, AP-HP, Universit��-Paris-Cit��, 92110, Paris, Clichy, France.
Jean Pasqueron: Department of Anesthesiology and Critical Care, Henri Mondor University Hospital, AP-HP, 94000, Creteil, France.
Lukshe Kanagaratnam: Universit�� de Reims Champagne-Ardenne, EA 3797 VieFra, F-51100, Reims, France.
Delphine Garrigue: Department of Anesthesiology and Critical Care, Lille University Hospital, 59000, Lille, France.
Emmanuel Rozenberg: Department of Anesthesiology and Critical Care, Georges Pompidou University Hospital, AP-HP, 75015, Paris, France.
Paul Mandrillon: Department of Anesthesiology and Critical Care, Kremlin-Bicetre University Hospital, AP-HP, 94270, Le Kremlin-Bicetre, France.
Julien Pottecher: Anesthesiology, Critical Care and Perioperative Medicine, Strasbourg University Hospital, 1 Avenue Moli��re, Strasbourg, France.
Pierre-Antoine Seube-Remy: Anesthesiology, Critical Care and Perioperative Medicine, Reims University Hospital, Hopital Maison Blanche, CHU de Reims, 45 Rue Cognacq Jay, 51092, Reims, Cedex, France.
Thomas Vettese: Department of Anesthesiology and Critical Care, Toulouse Purpan University Hospital, 31000, Toulouse, France.
Jean-Luc Hanouz: Department of Anesthesiology and Critical Care, Caen University Hospital, 14000, Caen, France.
Pierre Gosset: Department of Emergency Medicine, Amiens University Hospital, 80000, Amiens, France.
Benjamin Popoff: Department of Anesthesiology and Critical Care, Rouen University Hospital, 76000, Rouen, France.
Mathieu Willig: Department of Anesthesiology and Critical Care, Dijon University Hospital, 21000, Dijon, France.
Benjamin Cohen: Department of Anesthesiology and Critical Care, Tours University Hospital, 37000, Tours, France.
Fanny Bounes: Department of Anesthesiology and Critical Care, Toulouse Rangueil University Hospital, 31000, Toulouse, France.
Paer Selim Abback: Department of Anesthesiology and Critical Care, Tours University Hospital, 37000, Tours, France.
BACKGROUND: The aging population in France and Western Europe is on the rise, particularly among individuals aged 65 years and older. Although older adults are susceptible to traumatic injuries, they constitute a minority of trauma center admissions especially those aged 85 and above. The aim of our study was to investigate the prognostic factors for mortality among the older old population (aged 85 years and above) managed in ICU of Traumabase group trauma centers. METHODS: This retrospective observational cohort study, conducted from 2013 to 2022, analyzed all severely injured older patients (aged���������85 years) managed in 14 ICU trauma centers enrolled in the Traumabase registry. The study examined sociodemographic, clinical, and outcome variables. Frailty was assessed using the Clinical Frailty Scale. RESULTS: Among the 365 older trauma patients, 190 (52.1%) were classified as non-frail (CFS 1-3), 80 (21.9%) as pre-frail (CFS 4,5), and 95 (26%) as frail (CFS 6-9). Falls were the most common mechanism of injury. High mortality rates were observed, with 43.5% ICU mortality and 45.5% mortality at day 30. Factors most associated with ICU mortality included traumatic brain injury (CGS���<���13), pre-hospital micromethod hemoglobin���<���13 and severity of injury (ISS���>���16). CONCLUSION: Factors such as traumatic brain injury and severe hemorrhage (micromethod hemoglobin���<���13) and ISS���>���16 are associated with ICU mortality in in patients older than 85 years trauma patient. Early geriatric intervention is crucial for optimizing outcomes in this vulnerable population.
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