Doctors warn of 'poor' trauma care for elderly in the UK

Dr Andy EynonDoctors in Southampton have warned that major trauma admissions among the elderly are increasing across the UK – but their care is currently “poorly managed”.

Dr Andy Eynon, director of major trauma at Southampton General Hospital, said that patients over 65 were often “overlooked” as trauma cases despite accounting for more than a third of admissions.

Speaking ahead of the Wessex Trauma Network’s annual conference tomorrow (Tuesday), he said the issue – referred to as ‘silver’ trauma – required national attention to improve survival and also reduce the length of patients’ hospital stay and recovery.

“We have made fantastic progress in trauma care in the UK over the past couple of years with hundreds more lives saved, but elderly people have tended to be excluded from the bracket of major trauma,” he explained.

“This often results in delayed access to specialist trauma teams and, on some occasions, patients not being transferred from some hospitals to trauma centres that can provide the full range of care they require.”

Major trauma is the term used to describe life-threatening injuries commonly sustained through road traffic accidents, falls, violence or sporting injuries and it is the fifth most common cause of death in the elderly.

Southampton General Hospital is one of only 12 centres across the country to offer the full range of specialist surgical, intensive care and supporting services for both adults and children who suffer major trauma. 

It is supported by seven trauma units – based at Portsmouth, Basingstoke, Poole, Dorset, Salisbury, Chichester and on the Isle of Wight – as well as two ambulance services and the Hampshire and Isle of Wight Air Ambulance.

In Southampton, clinicians have developed a pioneering trauma and orthopaedic medical service, led by consultant ortho-geriatrician Dr Mark Baxter, to focus on care for the patients over 65 who suffer major trauma.

Dr Eynon added: “Nationally we are seeing a series of problems relating to elderly trauma. Many of these patients suffer simple falls and do not activate specialist trauma teams because they are seen simply as frail and put on a traditional treatment path for their age.

“This has a knock-on effect as the full diagnosis is often delayed and patients may not be referred to the designated major trauma centre where they might benefit from specialist care.”

Dr Laura Tompsett, who has received a fellowship to evaluate trauma care for over 65s, said: “Earlier identification of injuries and earlier ortho-geriatric input may lead to better and more timely decision making, earlier access to treatment and a faster, more co-ordinated period of recovery and rehabilitation.

“Ultimately, this may reduce length of stay and, more importantly, reduce complications and save lives in this vulnerable group of patients.”

The conference – Major trauma: Does age matter? – will take place tomorrow (Tuesday) at the Ageas Bowl in Southampton from 9.30am to 4.30pm.

It will see presentations from clinicians, a former patient who featured in the ITV1 documentary Trauma: Level 1 and Falklands War veteran Simon Weston.

Posted on Monday 22 September 2014