Facial Trauma in Elderly People Attended at General Hospital: Observational Study

In Brazil, the population has been going through a quick aging process, since the mid-1960s, due to a significant reduction in birth rate and to increased longevity. It is estimated that in 2020 the country's elderly population will reach the 30 million . World Health Organization (WHO) considers "elderly" over 65 years old in developing countries, and 60 years old in sub-developing countries. The aging process presents consequences to Brazilian society, as the country still has not managed subsidized social and economic changes that favor elderly people’s quality of life. Increasing life expectancy exposes elderly people to aggressive agents of modern life, exposing them to innumerous traumas, including oral maxillofacial trauma. The increasing incidence of traumatic events in elderly people can be related to health care advances which reach more individuals giving them the opportunity to arrive to an old productive age. The aged ones present characteristics of adult population under 60 year old, keeping their independence and autonomy, exposing themselves to traumatic events of varied causes, such as falls which are the most frequent causesof injury to this population, followed by transport accidents, aggression and violence. The aim of this work is to evaluate facial trauma etiology in elderly patients, so an observational, descriptive, transversal study with old people, both genders, with 60 years old or over, attended in the emergency room of a hospital in Rio Grande do Sul, Brazil. Data were collected from November 2014 to February 2016, in alternate days, considering sociodemographic variables and related to trauma with descriptive analyses to data. The total number of patients attended in this period of time was 230, 32 (13.9%) were 60 years old or more of these 18 (56.2%) were male and the average age was 74.2 (±8.6). The most prevalent trauma was falling (16-50%), follow by high level falling (5-15.6%), vehicle-related trauma (4-12.5%), motor vehicle accidents (2-6.2%), physical aggression (1-3.1%) and object collision (1-3.1%). 24 (75%) had soft tissues lesions and 21 (65.6%) had facial bone fractures. The two elderly patients who underwent high kinematic accidents died. Based on these results it can be concluded that prevalent etiology in elderly people was falling, suggesting the need of precocious diagnosis of pathologic causes (intrinsic) and extrinsic of the fall, creation of strategies to improve their life quality. The conclusion is that the elderly people who undergo high kinematic impact have the worst prognosis.

References:

Arcuri PM, Ramos NB, Scabar LF: Pacientes geriátricos no Brasil. Revista Instituto Ciências da Saúde 24(1): 43-45, jan.-marc. 2006.

DIAS E, et al: Trauma no idoso. Revista de Cirurgia e Traumatologia Buco- Maxilo-Facial; Pernanbuco 1(2): 7-12, jul.-dez. 2001.

MAESHIRO F L, et al: Capacidade funcional e a gravidade do trauma em idosos. Acta Paulista de Enfermagem; São Paulo 26(4): 389-94, 2013.

Instituto de estudos de saúde suplementar. Envelhecimento Populacional e os Desafios para o Sistema de Saúde Brasileiro. São Paulo. 2013.