Idealized for relaxation and leisure, reaching the golden years of life has been a romanticized goal after a lifetime of hard work. With the latest
census data revealing that people age 65 years and
older comprise the fastest-growing sector of the U.S.
population, it appears more Americans are entering
this stage of life.* In fact, the Centers for Disease
Control and Prevention estimate that by 2030, 19
percent of the population will be older than 65 years
of age.† While the carefree lifestyle of retirement
may be an aim for many, others find themselves
facing unanticipated challenges related to these
years. As the size of this population continues to
grow, so too will its presence in the trauma setting.
Geriatric trauma has long been recognized as a
unique challenge, largely because management
of injuries is often confounded by the presence of
pre-existing comorbidities related to the natural
aging process. These factors can lead to longer
hospitalization and a more challenging recovery.
Increasing injury rate in the elderly
While firearm-related injury is more common
among the younger population, mortality rates
for these injuries are increased in the elderly.
In reviewing the National Trauma Data Bank®
(NTDB®) datasets from admission years 2007 to
2014, along with the steady increase in firearm-related injuries in patients less than 65 years of
age, the data reveal a consistent rise in these
injuries among elderly patients (see Figures 1 and
2, this page). Notably, mortality after self-inflicted
firearm injury is highest among the elderly.‡
Guns and the golden years
by Richard J. Fantus, MD, FACS, and Lauren Sakai, MD
*U.S. Census Bureau. The Older Population: 2010. 2010 Census
Briefs. November 20, 2011. Available at: www.census.gov/prod/
cen2010/briefs/c2010br-09.pdf. Accessed September 15, 2016.
†Centers for Disease Control and Prevention. The State of
Aging and Health in America 2013. Available at: www.cdc.
in_america_2013.pdf. Accessed September 15, 2016.
‡Mathews EM, Woodward CJ, Musso M W, Jones GN. Suicide
attempts presenting to trauma centers: Trends across age groups using
the National Trauma Data Bank. Am J Emerg Med. 2016; 34( 8)1620-1624.
TOTAL FIREARM INJURIES, AGE ≥ 65
TOTAL FIREARM INJURIES, AGE < 65