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Invited Commentary
December 28, 2016

Future Directions of Geriatric Trauma CareFunction and Quality of Life Beyond Survival

Author Affiliations
  • 1Division of Trauma, Burn, and Critical Care, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Surg. Published online December 28, 2016. doi:10.1001/jamasurg.2016.4642

Elderly trauma patients are at high risk for poor outcomes, but traditional risk scoring systems fail to account for the declining physiologic reserve seen with aging known as frailty. The article by Kaplan et al1 in this issue of JAMA Surgery is timely in that it addresses a gap in our ability to use current frailty instruments in the trauma population, particularly in critically ill patients who are unable to complete functional testing. Finding new methods to understand aging physiology is a priority recently identified by the American Association for the Surgery of Trauma to improve care of the geriatric patient.2 This important work by Kaplan et al1 explores the association between sarcopenia, osteopenia, and 1-year mortality and, to my knowledge, is the first study to examine a combination of both radiologic markers as a risk factor for death after trauma. The authors are commended for keeping the focus on long-term mortality, which is of particular relevance to elderly patients, for whom the risk of death persists long after hospital discharge.3

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