Abstract
INTRODUCTION:.
Emergency department (ED) physicians are positions at a critical place in the management of the elderly trauma patient, however their contribution can reach far beyond the ED room. We reviewed here the results of guidelines and recommendations utilized to care for our elderly trauma patients.
METHODS:.
A retrospective analysis of patients seen in the ED between 2012-2022. In addition to geographical data collected are length of stay, morbidity, mortality, medications used, comorbid conditions. Statistical analysis using students t-test, chi square and regression analysis with a significant “p” value at less than 0.05. Internal Review Board approval was obtained prior to the studies.
RESULTS:.
Of 375 elderly patients with fragility fracture seen in the ED, those who referred to the fracture liaison service (FLS) showed significant reduction in the refracture rate (p < 0.01) compared to those before establishment of the FLS. Those elderly patients with traumatic brain injury (TBI) who sustained less than 4 mm bleed and were not on anti-coagulation therapy can safely be observed in the ED for less than 23 hours and don’t need a repeat CT scan or neurosurgery consult. The presence of skull fracture is an ominous sign and should raise the ED physician’s suspicion for worse things to come.
CONCLUSIONS:..
Emergency department physicians’ role in the care of the elderly trauma patients can reach far beyond the immediate ED room treatment. When these recommendations and guidelines are implemented, it will have a positive long-term influence on the elderly trauma patient.