Acil Servise Başvuran Geriatrik Travma Olgularının Görünteleme Bulgularının Analizi

Abstract

Geriatric trauma is defined as trauma occurring in the population aged 65 and above. Although the incidence of traumatic injury is less among the geriatric population, trauma associated mortality is higher in this age group. As the proportion of elderly people increases along with the aging worldwide population, the prevalence of geriatric trauma, together with the associated morbidity and mortality escalates. Therefore, the diagnostic and therapeutic issues related to trauma in the geriatric age group is becoming more important, both from the perspec- tive of medical and economic point of view. In this study, our aim was to analyze the imaging findings, in a series of geri- atric trauma patients admitted to our emergency department during the periods of 2006-2011 and 2012-2017. We also tried to determine the course of change over the years. Among 597 geriatric trauma patients admitted during the period of 2006-2011 we randomly selected a total of 300 patients, which comprised the first group in our study. Similarly, another randomly selected 300 cases out of 987 geriatric trauma patients admitted during 2012-2017 comprised the second group. Both groups were compared regarding various characteristics including age, gender, the reason for ad- mission, comorbidities, Revised Trauma Score (RTS), Glasgow Coma Scale (GCS), radiological findings, DLP values, duration of stay in the emergency department and hospital, trauma associated morbidities and mortalities. In addition the temporal trend regarding these characteristics were determined. The mean age was 76.6 years in group I and 78.5 years in group II. No signif- icant difference was observed between groups regarding age and gender. Approxi- mately 90% of patients in both groups had at least one chronic disease, with hyper- tension, coronary artery disease and diabetes mellitus constituting the most common comorbid conditions. Falls were the most common cause leading to admission in both groups (81% in group I, 90% in group II), followed by traffic accidents. RTS vi and GCS values were similar among both groups (p>0.05) Radiological evaluation with X-rays were performed in 82% of patients in group I, while CT was obtained in 44% of these cases. The proportion of patients undergoing X-ray and CT based radi- ologic evaluation was 89% and 73%, respectively, in group II. The total number of X-rays was 310 in group I and 613 in group II; the total number of CT‟s was 142 in group I and 409 in group II. These group-wise differences regarding the number of patients undergoing CT evaluation and the total number of studies were statistically significant (number of patients, p= 0.021, number of studies, p =0.010 ). Among pa- tients undergoing CT-based evaluation, no evidence of trauma related radiological findings was present in 49% of patients in group I and 55% of patients in group II. In patients with radiological evidence of trauma, no significant difference was observed between the groups regarding major pathological radiological findings (p=0.151). However, trauma related minor findings were significantly more common in patients evaluated by CT in group II (p=0.031). In conclusion, while the demographic characteristics, trauma mechanisms and trauma scores remained similar between the groups, the use of X-rays and CT inves- tigations significantly increased over the years.