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 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.
Author: | Cora Rebecca SchindlerORCiDGND, Mathias WoschekGND, René VerboketORCiDGND, Ramona SturmGND, Nicolas SöhlingGND, Ingo MarziORCiDGND, Philipp StörmannORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-555142 |
DOI: | https://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 |
Page Number: | 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: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Open-Access-Publikationsfonds: | Medizin |
Licence (German): | Creative Commons - Namensnennung 4.0 |