Keywords:
Emergency Imaging, Emergency, Trauma, CT, Decision analysis, Diagnostic procedure, Acute, Retrospective, Observational, Performed at one institution
Authors:
S. U. Patel, E. Cox, C. Solomonides, S. L. Dluzewski, F. Ingham; LONDON/UK
DOI:
10.26044/ecr2020/C-01073
Purpose
Major trauma in the elderly population is being identified as a substantial challenge to medical services (1). Furthermore, with medical advances the elderly now encompass the fastest growing group within the population, moreover it is predicted that by 2030 the number of people over 65 years-old in the United Kingdom (UK) will increase by 50% and those over 85 years-old by 100% (2). Ageing increases the probability of having a fall, alongside the risk of suffering a significant subsequent injury, and it means ones capability to recover is reduced (3). The report from the Trauma Audit and Research Network (TARN) identified that the demographics of major trauma is evolving (2).
The TARN report documented elderly trauma patients had longer identification times of serious injuries partially attributable to poor pre-hospital alert systems; subsequently this cohort of patients had fewer consultant and trauma team assessments (2). Additionally, the report commented that elderly patients were noted to have longer waiting times to undergo investigations and treatments (2). Furthermore, the most prevalent mechanism of injury identified in this age-group was a fall from standing height with injury to head and thorax being the commonest injury (2).
The purpose of the Silver Trauma Activation Criteria (STAC) tool (Figure 1) is to improve the prospective identification of serious injuries in patients over 70, who have had lower energy mechanisms of injury. Additionally, to ensure patients have prompt CT imaging and reporting.