RESEARCH ARTICLE


Low Energy Trauma in Older Persons: Where to Next?



Mellick Chehade*, 1, Tiffany K Gill2, Renuka Visvanathan3, 4
1 Discipline of Orthopaedics and Trauma, The University of Adelaide, Level 4, Bice Building, The Royal Adelaide Hospital, North Tce., Adelaide, SA, 5000, Australia
2 School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
3 Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA, 5011, Australia
4 4Adelaide Geriatrics Training and Research with Aged Care (G-TRAC) Centre, School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia


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© Chehade et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Discipline of Orthopaedics and Trauma, The University of Adelaide, Level 4, Bice Building, The Royal Adelaide Hospital, North Tce., Adelaide SA 5000 Australia; Tel: +61 8 82225661; Fax: +61 8 82323065; E-mail: mellick.chehade@adelaide.edu.au


Abstract

The global population is increasing rapidly with older persons accounting for the greatest proportion. Associated with this rise is an increased rate of injury, including polytrauma, for which low energy falls has become the main cause. The resultant growing impact on trauma resources represents a major burden to the health system. Frailty, with its related issues of cognitive dysfunction and sarcopenia, is emerging as the unifying concept that relates both to the initial event and subsequent outcomes. Strategies to better assess and manage frailty are key to both preventing injury and improving trauma outcomes in the older population and research that links measures of frailty to trauma outcomes will be critical to informing future directions and health policy. The introduction of “Geriatric Emergency Departments” and the development of “Fracture Units” for frail older people will facilitate increased involvement of Geriatricians in trauma care and aid in the education of other health disciplines in the core principles of geriatric assessment and management. Collectively these should lead to improved care and outcomes for both survivors and those requiring end of life decisions and palliation.

Keywords: Education, falls, fracture, frailty, geriatric, low energy trauma, older persons, polytrauma.