TY  - JOUR
A1  - Schindler, Cora Rebecca
A1  - Woschek, Mathias
A1  - Verboket, René
A1  - Sturm, Ramona
A1  - Söhling, Nicolas
A1  - Marzi, Ingo
A1  - Störmann, Philipp
T1  - Registry-based mortality analysis reveals a high proportion of patient decrees and presumed limitation of therapy in severe geriatric trauma
T2  - Journal of Clinical Medicine
N2  - 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.
KW  - polytrauma
KW  - trauma registry
KW  - geriatric patients
KW  - quality of life
KW  - severely injured
KW  - patient’s decree
KW  - mortality analysis
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55514
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-555142
SN  - 2077-0383
N1  - © 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/).
VL  - 9
IS  - 9, art. 2686
SP  - 1
EP  - 9
PB  - MDPI
CY  - Basel
ER  -