RT Book, Section A1 Stein, Deborah M. A1 Crawford, Angela M. A1 Yelon, Jay A. A2 Feliciano, David V. A2 Mattox, Kenneth L. A2 Moore, Ernest E. SR Print(0) ID 1175135301 T1 Geriatric Trauma T2 Trauma, 9e YR 2020 FD 2020 PB McGraw Hill PP New York, NY SN 9781260143348 LK accesssurgery.mhmedical.com/content.aspx?aid=1175135301 RD 2024/11/07 AB KEY POINTSFor the year 2016, the National Trauma Data Bank noted that 43% of all patients in the registry were 55 years or older and the mortality for this group was 58% of all deaths reported.There is evidence that immune function is significantly attenuated during the aging process and that cytokine response is impaired as well.In the event of hypovolemia secondary to trauma, the “stiffer” heart with atherosclerotic changes in elderly patients may be unable to compensate with tachycardia and an increase in cardiac output.The Trauma-Specific Frailty Index includes reviews of comorbidities, daily activities, health attitude, sexual function, and albumin level.In the National Trauma Triage Protocol, a systolic blood pressure of 110 mm Hg in an injured patient 65 years of age or older is a criterion for transport to a trauma center.When performing rapid sequence intubation in an elderly patient, the doses of induction agents may need to be reduced between 20% and 40% to minimize the risk of cardiovascular depression.Elderly patients on anticoagulants who have had a negative computed tomography (CT) scan of the brain after injury should have a follow-up CT of the brain before discharge from the emergency department, although the time frame for observation is controversial.Many of the falls in older trauma patients are from a standing height but still lead to significant injuries requiring hospitalization.Preexisting conditions such as cirrhosis, congenital coagulopathy, chronic obstructive pulmonary disease, ischemic heart disease, and diabetes mellitus have a significant negative impact on mortality in older trauma patients.Mortality in elderly trauma patients is significantly reduced in an intensivist-model intensive care unit (ICU) as compared to an open-model ICU.