ABSTRACT
The advanced-age trauma patient can pose particular clinical challenges that, while not unique to older age groups, tend to concentrate on older patients and negatively impact their posttrauma outcomes. Older patients are more likely to be taking a beta-blocker or oral anticoagulation or antiplatelet agent. These vulnerabilities, combined with greater diversity in the patient's or family's goals of care in the setting of acute illness, make the study of the advanced-age trauma patient worthwhile for the traumatologist. Integrating palliative care processes into ICU care may increase the rate of establishment of advance directives. Clinical measures such as the elevated base deficit, elevated TS, and extensive polytrauma in advanced-age patients predict very high mortality and can be used to aid in goals-of-care discussions. The use of anticoagulation in the elderly is increasing and is an important consideration in the trauma population, especially in the setting of traumatic brain injury.
