What question did this study set out to answer?

To identify clinical predictors of mortality in elderly patients with blunt multiple trauma and assess the impact of protocolized, emergent invasive hemodynamic monitoring.

July 1, 1988Journal of Trauma and Acute Care Surgery

Ceriatric Blunt Multiple Trauma

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Authors

TSThomas M. ScaleaUniversity of Bergamo ADAnthony J. DuncanUniversity of North Dakota NANabil AtwehJena University Hospital

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Implication

Observational study reveals high mortality and early occult pump failure in elderly blunt trauma patients, highlighting the critical role of rapid hemodynamic monitoring.

Key Points

To identify clinical predictors of mortality in elderly patients with blunt multiple trauma and assess the impact of protocolized, emergent invasive hemodynamic monitoring.
Analyzed 60 patients aged >65 years with blunt multiple trauma treated in 1985 to establish baseline risk factors for mortality.
Implemented prospective invasive hemodynamic monitoring in 1986 (N=15; mean delay 5.5 hours) and emergent monitoring in 1987–1988 (N=30; mean delay 2.2 hours) aiming to optimize volume, inotropes, and afterload reduction.
Predictors of mortality identified in the initial cohort included pedestrian-motor vehicle mechanism, initial blood pressure <150 mm Hg, acidosis, multiple fractures, and head injuries.
In the 1986 cohort, 8 of 15 patients presented with initial cardiac output <3.5 L/min or mixed venous oxygen saturation <50% and died of pump failure within 24 hours; overall survival was 7% (1 of 15) with multiple organ failure as the primary cause.
Reducing time to invasive monitoring to 2.2 hours in 1987–1988 identified initial cardiac output <3.5 L/min in 13 of 30 patients despite apparent hemodynamic stability.

Cite This Study

Scalea et al. (1988) studied this question.

synapsesocial.com/papers/6a700df2e36a167817e1c7d7 https://doi.org/10.1097/00005373-198807000-00086

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Implication

Observational study reveals high mortality and early occult pump failure in elderly blunt trauma patients, highlighting the critical role of rapid hemodynamic monitoring.

Ceriatric Blunt Multiple Trauma

Discussion

Member takes

Implication

Key Points

Cite This Study

Ceriatric Blunt Multiple Trauma

Discussion

Member takes

Implication

Key Points

Cite This Study

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