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.

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Author:Cora Rebecca SchindlerORCiDGND, Mathias WoschekGND, René VerboketORCiDGND, Ramona SturmGND, Nicolas SöhlingGND, Ingo MarziORCiDGND, Philipp StörmannORCiDGND
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
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
Issue:9, art. 2686
Page Number:9
First Page:1
Last Page:9
© 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 (
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0