Mortality in a low energy geriatric polytrauma patient

摘要

Geriatric patients presenting with a fracture, usually need expedited medical assistance and early surgery. Nonoperative care may or may not be an option. However, hypoalbuminemia is a sign of significant malnourishment and such patients should have carefully planned surgical procedures with nutritional supplementation. Large data bases have predicted mortality in such cases and surgical procedures should be limited to smaller life and limb-saving procedures performed with medical support. A careful team approach should be utilized in these patients with geriatrics, internal medicine, anesthesia and orthopedics working in concert with a sup- portive team of dietetics and physiotherapy. Some patients may require many short trips to the operating room to accomplish the same result as would occur with a healthy younger polytrauma patient. Severe malnourishment may preclude all but life-saving surgery in an elderly patient presenting with geriatric polytrauma. A serum albumin of greater than 3.5g/L is the goal of medical management such that wound healing and recovery can be accomplished with a geriatric polytrauma patient.