2023 ACS Geriatric Trauma Management Best Practice Guidelines Summary

Introduction and Acute Care

Trauma in older adults is increasing, both in number of cases and as a proportion of the total trauma center volume.
Unintentional injury is the seventh leading cause of death for older adults.
The outcomes for older adult trauma patients are worse than for younger trauma patients; older age is an independent risk factor for mortality.
Falls are the most common cause of injury in older adults and the leading cause of fatal injury.
Suicide rates are highest among older adults when compared with other age groups.

Optimal trauma care of the older adult patient must factor in any comorbidities, geriatric-specific syndromes, and reduced physiologic reserve.
Frailty syndrome involves decreased physiologic reserves across multiple organ systems, and it is associated with worse outcomes and increased mortality.
In trauma patients, frailty is often more predictive of adverse outcomes than age.
The Trauma-Specific Frailty Index (TSFI) is an effective, validated tool that can aid clinicians in identifying high risk patients and planning their care.
Early assessment and identification of patients with frailty is essential to optimize their care by involving interprofessional teams and implementing focused management plans.

Geriatric Trauma Management