145 Aldrian et al., Geriatric polytrauma Wien Klin Wochenschr (2005) 117/4: 145–149 DOI 10.1007/s00508-004-0290-y Original Article Received April 15, 2004, accepted after revision October 18, 2004 © Springer-Verlag 2005 Summary. Background: compared to a younger pop- ulation, the treatment of geriatric trauma victims is known to be associated with a higher mortality and morbidity. The objectives of this study are to assess the clinical course and outcome of multitrauma patients aged 65 years and over. In addition, a direct comparison between the geriatric trauma patients and the younger collective is performed. Method: our study includes all multitrauma patients treated between 1992 and 2001 at a major urban trauma center. The major issues of this analysis are: injury sever- ity, injury pattern, preclinical hemodynamics and intuba- tion rate, operative treatment, ventilation time, outcome as well as incidence of multiorgan failure (MOF) and adult respiratory distress syndrome (ARDS). Out of these re- sults, adults over 65 years of age (group B, n = 45) are compared to the younger group, ranging from 16 to 64 years of age (group A, n = 369). Results: The preclinical intubation rate was compara- ble in both groups (A: 73.2%, B: 68.9%). Significantly more cases of group B were primarily shocked (A: 29.0%, B: 48.9%). The mean ISS was comparable in both groups (A: 34.0; B: 32.1). The younger group showed a signifi- cantly higher incidence of spine injuries (A: 21.1%; B: 6.7%). The number of emergency procedures (A: 24.2%; B: 24.4%) and operations during the first 24 hours (A: 70.2%; B: 60.0%) was comparable in both groups. The older group showed a lower number of reconstructive operations (A: 57.6%; B: 35.6%). Geriatric trauma pa- tients had a longer ventilation time compared to their younger counterparts (A: 13.0 days, B: 20.0 days). During ICU-therapy, the ARDS rate was comparable (A: 16.0%, B: 15.6%). In contrast, the incidence of MOF was signif- icantly higher in group B (A: 7.1%; B: 17.8%). The older group showed a significantly higher mortal- ity rate (A: 26.8%; B: 53.3%) as well as early mortality during the first 24 hours after admission (A: 16.3%, B: 31.11%). Conclusion: Despite similarity in injury severity and a comparable injury pattern, elderly multitrauma patients initially presented a higher rate of hemodynamic instabil- ity, had to be ventilated longer and had a higher mortality. Key words: Geriatric, polytrauma, injury severity, in- jury pattern, mortality. Introduction It is estimated, that the proportion of elderly people in our population will rise rapidly. In the year 2000, 20.7% of the Austrian population was older than 60 years. In the year 2030, 32.2% will be counted to this age group [1]. Reasons for the increasing rate of older people with mul- tiple injuries are, on the one hand, an increasing life expectancy and declining birth rate, on the other hand, the higher mobility of older people. The outcome and prognosis of geriatric trauma pa- tients has become a matter of concern in recent years. In a previous study, it was reported that older trauma patients had a higher mortality due to the development of septic complications [2]. One major complicating factor respon- sible for the bad outcome is the limited physiological reserve in elderly people. Other reasons for the increased mortality rate in elderly trauma patients are preexisting pulmonary and cardiopulmonary diseases. It was the aim of the present study to analyze injury severity, preclinical state, treatment, ventilation time, complications and outcome of geriatric trauma patients. In addition, we aimed to directly compare this group of multitrauma patients with a younger control group. Study population and methods Data were obtained from a level I academic trauma center. Since September 1992, all patients seen at our major urban trauma center are being entered into a computerized trauma database and our study includes patients up to December 2001. We collected data on all polytrauma patients admitted to the hospital for at least one day, as well as all patients declared dead in the emergency department. The study includes all polytrauma patients, defined as injuries of two or more body cavities, or injury of one body cavity and two long bone fractures. Not included are patients with isolated, severe, poten- tially life-threatening injuries. Out of these data, including all age groups, adults aged 65 years or older (group B) were compared to the younger group aged from 16 to 64 years (group A). Geriatric polytrauma Silke Aldrian 1 , Thomas Nau 1 , Franz Koenig 2 , and Vilmos Vécsei 1 1 Department of Trauma Surgery and 2 Department of Medical Statistics, University of Vienna Medical School, Vienna, Austria WIENER KLINISCHE WOCHENSCHRIFT The Middle European Journal of Medicine Printed in Austria