Skip to main content

Outcomes for Surgical Care in the Elderly

  • Chapter
  • First Online:
Geriatric Trauma and Critical Care

Abstract

Outcomes in geriatric trauma and surgery have received extensive attention in recent peer-reviewed literature. As noted by Maxwell in the previous edition of this chapter [1], there were more than 80 published studies between 1980 and 2014, and in 2015 alone, a search of the Google Scholar web site lists more than 4000 references under the search term “outcomes in geriatric trauma.”

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Maxwell C, Rader EL, Fallon WF. Outcomes for surgical care in the elderly. In: Yelon JA, Luchette FA, editors. Geriatric trauma and critical care. New York: Springer Scientific + Business Media; 2014. p. 225–35.

    Chapter  Google Scholar 

  2. Grossman MD, Miller DA, Scaff D, Arcona S. When is an elder old? Effect of preexisting conditions on mortality in geriatric trauma patients. J Trauma. 2004;56(6):1297–304.

    Article  Google Scholar 

  3. Richmond T, Kauder D, Strumpf N, Meredith T. Characteristics and outcomes of serious traumatic injury in older adults. J Am Geriatr Soc. 2002;50(2):215–22.

    Article  PubMed  Google Scholar 

  4. Grossman MD, Scaff D, Miller D, Reed J, et al. Functional outcomes in octogenarian trauma. J Trauma. 2003;55(1):26–32.

    Article  PubMed  Google Scholar 

  5. Morris J, MacKenzie E, Edelstein S. The effect of pre-existing conditions on mortality in trauma patients. JAMA. 1990;263(14):1942–6.

    Article  PubMed  Google Scholar 

  6. Nirula R, Gentilello LM. Futility of resuscitation criteria for the “young” old and the “old” old trauma patient: a National Trauma Data Bank Analysis. J Trauma. 2004;57(1):37–41.

    Article  PubMed  Google Scholar 

  7. Grossman M, Offurum A, Stehly C, et al. Long term survival after major trauma in geriatric trauma patients: the glass is half full. J Trauma Acute Care Surg. 2012;72(5):1181–5.

    Article  PubMed  Google Scholar 

  8. Konda S, Lack W, Seymour R, Karunakar M. Mechanism of injury differentiates risk factors for mortality in geriatric trauma patients. J Ortho Trauma. 2015;29(7):331–6.

    Article  Google Scholar 

  9. Battistella F, Din A, Perez L. Trauma patients 75 years and older: long-term follow-up results justify aggressive management. J Trauma. 1998;44(4):618–24.

    Article  CAS  PubMed  Google Scholar 

  10. Newell MA, Schlitzkus L, Waibel B, et al. “Damage Control” in the elderly: futile endeavor or fruitful enterprise? J Trauma Acute Care Surg. 2010;69(6):1049–53.

    Article  Google Scholar 

  11. Pearse MA, Harrison DA, Neil-Macdonald, et al. Effect of perioperative cardiac output guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery. JAMA. 2014;311:2181–90.

    Article  CAS  PubMed  Google Scholar 

  12. Joseph B, Pandit V, Zangbar V, et al. Superiority of frailty over age in predicting outcomes among geriatric trauma patients. JAMA Surg. 2014;149(6):766–72.

    Article  PubMed  Google Scholar 

  13. Maxwell CA, Mion LC, Mukherjee K, et al. Feasibility of screening for pre-injury frailty in hospitalized injured older adults. J Trauma Acute Care Surg. 2015;78(4):844–51.

    Article  PubMed  Google Scholar 

  14. Robinson TN, Walston JD, Brummel NE, et al. Frailty for surgeons: review of a National Institute for Aging conference on frailty for specialists. JACS. 2015;221(6):1083–91.

    Google Scholar 

  15. Scarbourough JE, Benett KM, Englum BR, et al. The impact of functional dependency on outcomes after complex general and vascular surgery. Ann Surg. 2015;261(3):432–7.

    Article  Google Scholar 

  16. Bilimoria K, Yaoming L, Paruch JL, et al. Development and evaluation of the Universal ACS NSQIP Surgical Risk Calculator: a decision aid and informed consent tool for patients and surgeons. JACS. 2013;217(5):833–42.

    Google Scholar 

  17. Partridge J, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Aging. 2012;41(2):142–7.

    Article  Google Scholar 

  18. Joseph B, Pandit V, Khalil M, et al. Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer? J Trauma Acute Care Surg. 2014;76(7):196–200.

    Article  PubMed  Google Scholar 

  19. Khalil M, Pandit V, Rhee P, et al. Certified acute care surgery programs improve outcomes in patients undergoing emergency surgery: a nationwide analysis. J Trauma Acute Care Surg. 2015;79(1):60–4.

    Article  PubMed  Google Scholar 

  20. Chang DC, Bass RR, Cornwell EE, MacKenzie E. Undertriage of elderly trauma patients to state-designated trauma centers. Arch Surg. 2008;143(8):776–81.

    Article  PubMed  Google Scholar 

  21. Lane P, Sorondo B, Kelly JJ. Geriatric trauma patients-are they receiving trauma center care? Acad Emerg Med. 2003;10(3):244–50.

    PubMed  Google Scholar 

  22. Rotondo MF, Crubani C, Smith RS. American college of surgeons chiccago, “Geriatric Trauma” in advanced trauma life support manual, 9th ed. American college of Surgeons Committee on Trauma; 2012.

    Google Scholar 

  23. Oyetunji T, Chang DC, Crompton JG, et al. Redefining hypotension in the elderly: normotension is not reassuring. Arch Surg. 2011;146:865–9.

    Article  PubMed  Google Scholar 

  24. SPARCS data, New York State administrative data 2014.

    Google Scholar 

  25. Gage AM, Traven N, Rivara F, et al. Compliance with centers for disease control and prevention field triage guidelines in an established trauma system. JACS. 2012;215(1):148–54.

    Google Scholar 

  26. Meldon SW, Reilly M, Drew B, et al. Trauma in the very elderly: a community based study of outcomes at trauma and non-trauma centers. Acad Emerg Med. 2000;7(10):1166.

    Google Scholar 

  27. Demitriades D, Sava J, Alo K, et al. Old age as a criterion for trauma team activation. J Trauma. 2001;51(4):754–6.

    Article  Google Scholar 

  28. Zocchi HRY, Carr BG, Sarani B. Comparison of mortality at trauma and non-trauma centers for minor and moderately severe injuries in California. Ann Emerg Med. 2016;67(1):56–67.

    Article  PubMed  Google Scholar 

  29. Gomez D, Haas B, Hennilia M, et al. Hips can lie: impact of excluding isolated hip fractures on external benchmarking of trauma center performance. J Trauma Acute Care Surg. 2010;69(1):1037–41.

    Article  Google Scholar 

  30. Matsushima K, Schaefer EW, Won E, et al. Positive and negative volume-outcome relationships in the geriatric trauma population. JAMA Surgery. 2014;149(4):319–26.

    Article  PubMed  Google Scholar 

  31. Zafar SN, Obirieze A, Schneider EB, et al. Outcomes of trauma care at centers treating a higher proportion of older patients: the case for geriatric trauma centers. J Trauma Acute Care Surg. 2015;78(4):852–9.

    Article  PubMed  Google Scholar 

  32. Fallon Jr WF, Rader E, Zyzanski S, et al. Geriatric outcomes are improved by a geriatric trauma consultation service. J Trauma. 2006;54:849–51.

    Google Scholar 

  33. Mangram AJ, Mitchell CD, vk S, et al. Geriatric trauma service: a one-year experience. J Trauma Acute Care surg. 2012;72(1):119–22.

    Article  PubMed  Google Scholar 

  34. Lenartowicz M, Parkovnick M, McFarlan A, et al. An analysis of a proactive geriatric trauma consultative service. Ann. Surg. 2012;256(6):1098–101.

    Article  PubMed  Google Scholar 

  35. Kozar RA, Arbabi S, Stein D, et al. Injury in the aged: geriatric trauma care at the crossroads. J Trauma Acute Care Surg. 2015;78(6):1197–209.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Ayoung-Chee PR, Rivara FP, Weiser T, et al. Beyond the hospital doors: Improving long term outcomes for the elderly trauma patient. J Trauma Acute Care Surg. 2015;78(4):837–43.

    Article  PubMed  Google Scholar 

  37. Horn S. What works in inpatient traumatic brain injury rehabilitation: results from the traumatic brain injury-practice based evidence study. Arch Phys Med and Rehab. 2015;96(suppl 8):S178–96.

    Article  Google Scholar 

  38. Moore L, Hanley J, Turgeon A, Lavoie A. Comparing regression-adjusted mortality to standardized mortality ratios for trauma center profiling. J Emerg Trauma Shock. 2012;5(4):333–7.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Dy C, Dossous P-M, Ton Q, et al. The medical orthopedic trauma service: an innovative multidisciplinary team model that decreases in-hospital complications in patients with hip fractures. J Ortho Trauma. 2012;26(6):379–83.

    Article  Google Scholar 

  40. Fu TS, Rowan J, McFall SR, Cusimano MD. Recent trends in hospitalization and in hospital mortality associated with traumatic brain injury in Canada: a nationwide population based study. J Trauma Acute Care Surg. 2015;79(3):449–55.

    Article  PubMed  Google Scholar 

  41. McIntyre A, Mehta J, Aubut J, et al. Mortality among older adults with traumatic brain injury: a meta-analysis. Brain injury. 2013;27(2):31–40.

    Article  PubMed  Google Scholar 

  42. Seelig JM, Becker DM, Miller JD. Major mortality reduction in comatose patients treated within four hours. NEJM. 1981;304:1511–8.

    Article  CAS  PubMed  Google Scholar 

  43. Stochetti N, Paterno R, Citerio G, et al. Traumatic brain injury in an aging population. J Neurotrauma. 2012;29:1119–25.

    Article  Google Scholar 

  44. Lau D, Abdulrahman M, Ziewicz JE, et al. Post-operative outcomes following closed head injury and craniotomy for evacuation of hematoma in patients older than 80 years. J neurosurgery. 2012;116(3):234–45.

    Article  Google Scholar 

  45. Miranda LB, Braxton E, Hobbs J, MR Q. Chronic subdural hematoma in the elderly: not a benign disease. J neurosurgery. 2012;114(1):72–5.

    Article  Google Scholar 

  46. Suzuki J, Takaku A. Non-surgical treatment of chronic subdural hematoma. J Neurosurgery. 1970;33:548–53.

    Article  CAS  Google Scholar 

  47. Wang H, Coppola M, Robinson R, et al. Geriatric trauma patients with cervical spine fractures after ground level falls at a level 1 trauma center. J Clin Med Res. 2013;5:75–83.

    PubMed  PubMed Central  Google Scholar 

  48. Fagin AM, Cippole MD, Barraco RD, et al. Odontoid fractures in the elderly: Should we operate? J Trauma. 2010;68(3):583–6.

    Article  PubMed  Google Scholar 

  49. Majercik S, Tashjian RZ, Biffl WL, et al. Halo vest immobilization in the elderly: a death sentence? J trauma. 2005;59(2):350–6.

    Article  PubMed  Google Scholar 

  50. Sharpe JP, Magnotti LJ, Weinberg J, et al. The old man with the C-spine fracture: impact of halo vest stabilization in patients with blunt cervical spine fractures. J Trauma Acute care Surg. 2015;80(1):76–80.

    Article  Google Scholar 

  51. Chapman J, Smith JS, Kopjar B, et al. The AOS North American Geriatric Odontoid Fracture Mortality Study. Spine. 2013;38(13):1098–104.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Schoenfield AJ, Bono CM, Reichman WM, et al. Type II fractures of the cervical spine. Spine. 2011;36(11):879–85.

    Article  Google Scholar 

  53. Smith JS, Kepler C, Kpjar B, et al. effect of type II odontoid fracture non-union on outcome among elderly patients treated without surgery based upon the AOS North American Geriatric Odontoid fracture Study. Spine. 2013;38(26):2240–6.

    PubMed  Google Scholar 

  54. Vaccaro AR, Kepler C, Kopjar B, et al. Functional and quality of life outcomes in geriatric patients with type 2 dens fracture. JBJS. 2013;95:729–35.

    Article  Google Scholar 

  55. Pennsylvania trauma outcome study database. Mechanicsville: PTSF (Accessed on 10th NOV 2016).

    Google Scholar 

  56. National Trauma Data Bank. Available at https://www.facs.org/.../trauma/ntdb.

  57. Hung WW, Egol K, Zukerman JD, Siu AL. Hip fracture management: tailoring care for the older patient. JAMA. 2012;307(20):2185–94.

    Article  CAS  PubMed  Google Scholar 

  58. Hannan EL, Magaziner J, Wang JJ, et al. Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA. 2001;285(21):2736–42.

    Article  CAS  PubMed  Google Scholar 

  59. Vidan MT, Sanchez E, Gracia Y, et al. Causes and effects of surgical delay in patients with hip fracture: a cohort study. Ann Intern Med. 2011;155(4):226–33.

    Article  PubMed  Google Scholar 

  60. Chesters A, Atkinson. Fascia iliac nerve block for pain relief from proximal femoral fracture in the emergency department: a review of the literature. Emerg Med J. 2014;31(e1):e84–7.

    Article  PubMed  Google Scholar 

  61. Adunsky A, Lerner-Giva L, Blumstein T, et al. Improved survival of hip fracture patients treated within a comprehensive hip fracture unit, compared with standard of care treatment. J Am Med Dir Assoc. 2011;12(6):439–44.

    Article  PubMed  Google Scholar 

  62. Pedersen SJ, Borgbjerg FM, Schousboe B, et al. Hip Fracture Group of the Bispebjerg Hospital: a comprehensive hip fracture program reduces complication rates and mortality. J Am Geriatr soc. 2008;56(10):1831–8.

    Article  PubMed  Google Scholar 

  63. Binder EF, Brown M, Sinacore DR, et al. effects of extended outpatient rehab after hip fracture: a randomized controlled trial. JAMA. 2004;292(7):837–46.

    Article  CAS  PubMed  Google Scholar 

  64. Carmeli E, Sheklow SL, Coleman R. A comparative study of organized class-based exercise programs versus individual home-based exercise programs for elderly patients following hip surgery. Disabil Rehabil. 2006;28(16):997–1005.

    Article  PubMed  Google Scholar 

  65. Sise M, Sise BC, Thorndike J, et al. Withdrawal of care: a ten-year experience in a Level I trauma center. J Trauma Acute Care Surg. 2012;72(5):1186–93.

    Article  PubMed  Google Scholar 

  66. Mosenthal A, Murphy A, Barker L, et al. Changing the culture around end of life care in the ICU. J Trauma Acute Care Surg. 2008;64(6):1587–93.

    Article  Google Scholar 

  67. Maerz LL, Mosenthal AM, Mller RS, Cotton B, Kirton O. futility and the acute care surgeon: the AAST futility study. J Trauma acute Care Surg. 2015;78(6):1216–9.

    Article  PubMed  Google Scholar 

  68. Reuben PR, Tinetti ME. Goal-oriented care patient care-an alternative health care paradigm. NEJM. 2012;366:777–9.

    Article  CAS  PubMed  Google Scholar 

  69. American Geriatrics Society Expert Panel on the Care of older Adults with Multimorbidity. Patient centered care for older adults with multiple chronic conditions: a stepwise approach. J Am Geriatric Soc. 2012;60:1957–68.

    Article  Google Scholar 

  70. Kozar RA, Holcomb JB, Xiong W, Nathens AB. Are all deaths recorded equally? The impact of hospice care on risk adjusted mortality. J Trauma Acute Care Surg. 2014;76(3):634–9.

    Article  PubMed  Google Scholar 

  71. Shahian DM, Wolf RE, Iezzoni LI, et al. Variability in the measurement of hospital wide mortality. NEJM. 2010;363:1376–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Grossman, M.D. (2017). Outcomes for Surgical Care in the Elderly. In: Luchette, F., Yelon, J. (eds) Geriatric Trauma and Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-48687-1_25

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48687-1_25

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48685-7

  • Online ISBN: 978-3-319-48687-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics