ArticleJournal of the American College of Surgeons2020
Age-Dependent Association of Occult Hypoperfusion and Outcomes in Trauma.
Article in Journal of the American College of Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- Trauma as a critical condition in the very old: assessment, care pathways and outcome differences.European geriatric medicine · 2026Review
- Evaluation of the role of repeated inferior vena cava sonography in estimating first 24 h fluid requirement in resuscitation of major blunt trauma patients in emergency department Suez Canal University Hospital.BMC emergency medicine · 2024Article
- Skin mottling score assesses peripheral tissue hypoperfusion in critically ill patients following cardiac surgery.BMC anesthesiology · 2024Article
- Identifying Age-Specific Risk Factors for Poor Outcomes After Trauma With Machine Learning.The Journal of surgical research · 2024Article
- Occult hypoperfusion and changes of systemic lipid levels after severe trauma: an analysis in a standardized porcine polytrauma model.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Geriatric trauma triage: optimizing systems for older adults-a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee.Trauma surgery & acute care open · 2024Review
- Factors Associated with 1-Year Mortality in Elderly Patients (Age ≥ 80 Years) with Cancer Undergoing Major Abdominal Surgery: A Retrospective Cohort Study.Annals of surgical oncology · 2023Article
- Interpreting Infrared Thermography with Deep Learning to Assess the Mortality Risk of Critically Ill Patients at Risk of Hypoperfusion.Reviews in cardiovascular medicine · 2023Article
- Do entrapment, injuries, outcomes and potential for self-extrication vary with age? A pre-specified analysis of the UK trauma registry (TARN).Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Geriatric polytrauma patients should not be excluded from aggressive injury treatment based on age alone.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Dysphagia is associated with worse clinical outcomes in geriatric trauma patients.Trauma surgery & acute care open · 2022Article
- Importance of duration of acute kidney injury after severe trauma: a cohort study.Trauma surgery & acute care open · 2021Article
Corrections and comments
- Commented on byDiscussion.2020
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundOccult hypoperfusion (OH), or global hypoperfusion with normal vital signs, is a risk factor for poor outcomes in elderly trauma patients. We hypothesized that OH is associated with worse outcomes than shock in both young and elderly trauma patients.
methodsWe conducted a single-center cohort study of adult (16 years or older) trauma patients from 2016 to 2018 with base excess measured on arrival. Perfusion states were defined as shock if heart rate was >120 beats/min or systolic blood pressure was <90 mmHg; OH if base excess was < -2 mmol/L, heart rate was <120 beats/min, and systolic blood pressure was >90 mmHg; and normal for all others. Patients were stratified as young (younger than 55 years) or elderly (55 years or older). Bayesian regression was used to assess the relationship between arrival perfusion state and mortality or serious complication.
resultsOf 3,126 included patients, 808 were elderly. Rates of shock (33% and 31%) and OH (25% and 23%) were similar in young and elderly patients, respectively. OH on arrival was associated with higher odds of mortality or serious complication than normal perfusion, regardless of age group. Compared with shock, OH was associated with an odds ratio of 1.21 (95% CI, 0.97 to 1.52, posterior probability 96%) for poor outcomes in elderly patients and an odds ratio of 0.52 (95% CI, 0.42 to 0.65, posterior probability <1%) for poor outcomes in younger patients. Findings were similar on sensitivity analysis, excluding shock patients with base excess ≥ -2 mmol/L.
conclusionsIn elderly but not younger patients, OH is associated with worse outcomes than shock. Although shock parameters might need to be redefined in elderly patients, more attention is necessary for the diagnosis and treatment of all hypoperfused states in this age group.
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