The vulnerability of the geriatric population is a pressing issue, especially in the face of aging, socioeconomic disparities, and marginalization. In Germany, the situation is dire, with a significant portion of the elderly population at risk of poverty, and the SARS-CoV-2 pandemic only exacerbating these challenges. This study aims to shed light on the trends and complexities of geriatric head and neck trauma, focusing on the period from 2018 to 2024, which encompasses pre-pandemic, pandemic, and post-pandemic phases.
Conducted at a level 1 trauma center, the research utilized data from the Dortmund Maxillofacial Trauma Registry, encompassing over 14,500 cases from 2007 to 2024. Fractures were categorized according to AO guidelines, and a comprehensive analysis was performed, including demographic factors, fracture distribution, and the presence of other medical conditions.
The study analyzed 973 geriatric head and neck trauma cases, with falls being the predominant cause (82.6%). The average patient had 2.6 comorbidities, with hypertension affecting 64% of the cases. Interestingly, there was a significant decrease in male case numbers in 2021, with a 73% drop. Injuries primarily affected the midface, and 52% of the cases required surgical intervention. The pandemic's impact on these trends highlights the intricate nature of geriatric trauma and the specialized care required.
Our findings present a comprehensive overview of geriatric head and neck traumatology, focusing on two age groups: 65-75 years and those over 75. Males dominated the 65-70 age group (p < 0.001), but above 75, females took the lead. The SARS-CoV-2 pandemic brought about extreme fluctuations in case numbers, with a 30% rise in females and a staggering 90% increase in males in 2021, followed by a record low in 2022. Cerebral injuries were prevalent, affecting 49.3% of patients, and the average patient had 2.6 comorbidities, with 52% requiring surgery. Anticoagulant therapy was common, with approximately 74% on antiplatelet therapy and 26% on anticoagulants. Falls were the primary cause of injuries, with the nasal bone, zygomatic bone, and orbital floor being the most affected, indicating a high vulnerability in this population.
The study reveals the volatility of case numbers post-SARS-CoV-2, with males disproportionately affected. A significant proportion of the elderly population is on anticoagulants, and among the injured, there is a high rate of cerebral injury. Most fractures occur in exposed facial regions, emphasizing the need for ongoing surveillance to address the increasing vulnerability of the geriatric population.
Data availability is governed by various legal frameworks, and as such, the data is available on-site, adhering to the regulations of Dortmund General Hospital.
This study provides valuable insights into the complexities of geriatric trauma, and we encourage further discussion and exploration of these findings. Do you think the pandemic's impact on healthcare access played a significant role in the observed trends? What measures do you think can be implemented to improve the care and safety of the geriatric population, especially in the face of such vulnerabilities?
