Review of trauma scoring systems in geriatric patients

As the aging population progresses, more and more traumatic events involve the elderly. Given the systemic "frailty" of the elderly, there is currently no universally accepted method for geriatric trauma assessment. The existing methods for assessing geriatric trauma patients - the Geriatric Trauma Outcome Score (GTOS), the Elderly Mortality After Trauma (EMAT), and Geriatric Trauma Mortality Score (GERtality)-were reviewed. GTOS, GERtality and EMAT have 3, 5 and 26 parameters, respectively. EMAT contains almost every aspect of clinical scenarios, such as demographic data, comorbidities, injury type, and abnormal physiologic markers, and seems to be more reliable than the other 2. GTOS contains only age, severity of injury and the need for blood transfusion. GERtality covers age, comorbidities, severity of craniocerebral injury, severity of injury, and hemorrhage. However, EMAT calculation is complex, while GERtality and GTOS are user friendly. Our review shows that each of 3 scores has limitations and lacks further validation. GERtality contains more "fragile" information than GTOS and is more user friendly than EMAT. It might be more practical clinically. More research is needed in geriatric trauma evaluation.