@article{ref1,
title="Registry-based mortality analysis reveals a high proportion of patient decrees and presumed limitation of therapy in severe geriatric trauma",
journal="Journal of clinical medicine",
year="2020",
author="Schindler, C.R. and Woschek, M. and Verboket, R.D. and Sturm, R. and Söhling, N. and Marzi, I. and Störmann, P.",
volume="9",
number="9",
pages="1-9",
abstract="BACKGROUND: The treatment of severely injured patients, especially in older age, is complex, and based on strict guidelines. <br><br>METHODS: We conducted a retrospective study by analyzing our internal registry for mortality risk factors in deceased trauma patients. All patients that were admitted to the trauma bay of our level-1-trauma center from 2014 to 2018, and that died during the in-hospital treatment, were included. The aim of this study was to carry out a quality assurance concerning the initial care of severely injured patients. <br><br>RESULTS: In the 5-year period, 135 trauma patients died. The median (IQR) age was 69 (38-83) years, 71% were male, and the median (IQR) Injury Severity Score (ISS) was 25 (17-34) points. Overall, 41% of the patients suffered from severe traumatic brain injuries (TBI) (AIShead ≥ 4 points). For 12.7%, therapy was finally limited owing to an existing patient's decree; in 64.9% with an uncertain prognosis, a 'therapia minima' was established in consensus with the relatives. <br><br>CONCLUSION: Although the mortality rate was primarily related to the severity of the injury, a significant number of deaths were not exclusively due to medical reasons, but also to a self-determined limitation of therapy for severely injured geriatric patients. The conscientious documentation concerning the will of the patient is increasingly important in supporting medical decisions. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.<p /><p>Language: en</p>",
language="en",
issn="2077-0383",
doi="10.3390/jcm9092686",
url="http://dx.doi.org/10.3390/jcm9092686"
}