Registry-based mortality analysis reveals a high proportion of patient decrees and presumed limitation of therapy in severe geriatric trauma

Background: The treatment of severely injured patients, especially in older age, is complex, and based on strict guidelines. Methods: We conducted a retrospective study by analyzing our internal registry for mortality ri
Background: The treatment of severely injured patients, especially in older age, is complex, and based on strict guidelines. Methods: We conducted a retrospective study by analyzing our internal registry for mortality risk factors in deceased trauma patients. All patients that were admitted to the trauma bay of our level-1-trauma center from 2014 to 2018, and that died during the in-hospital treatment, were included. The aim of this study was to carry out a quality assurance concerning the initial care of severely injured patients. Results: In the 5-year period, 135 trauma patients died. The median (IQR) age was 69 (38–83) years, 71% were male, and the median (IQR) Injury Severity Score (ISS) was 25 (17–34) points. Overall, 41% of the patients suffered from severe traumatic brain injuries (TBI) (AIShead ≥ 4 points). For 12.7%, therapy was finally limited owing to an existing patient’s decree; in 64.9% with an uncertain prognosis, a ‘therapia minima’ was established in consensus with the relatives. Conclusion: Although the mortality rate was primarily related to the severity of the injury, a significant number of deaths were not exclusively due to medical reasons, but also to a self-determined limitation of therapy for severely injured geriatric patients. The conscientious documentation concerning the will of the patient is increasingly important in supporting medical decisions.
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Author:Cora Rebecca Schindler, Mathias Woschek, René Verboket, Ramona Sturm, Nicolas Söhling, Ingo Marzi, Philipp Störmann
URN:urn:nbn:de:hebis:30:3-555142
DOI:http://dx.doi.org/10.3390/jcm9092686
ISSN:2077-0383
Parent Title (English):Journal of Clinical Medicine
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2020/08/19
Date of first Publication:2020/08/19
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/09/10
Tag:geriatric patients; mortality analysis; patient’s decree; polytrauma; quality of life; severely injured; trauma registry
Volume:9
Issue:9, art. 2686
Pagenumber:9
First Page:1
Last Page:9
Note:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
HeBIS PPN:469758511
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Licence (German):License LogoCreative Commons - Namensnennung 4.0

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