A medicolegal evaluation of geriatric cases with traumatic injuries

BACKGROUND: The morbidity and mortality of traumatic injuries are higher in individuals aged >65 years, which are a population group showing an increase worldwide, compared to other age groups. The aim of this study was to compare the medicolegal aspects, such as abuse of the elderly with the morbidity and mortality rates of injuries resulting from trauma by examining the age, gender, trauma history, type of traumatic injury, clinical progress following injury, elderly abuse, and the care environment of the person in cases aged 65 years and older.
METHODS: In this cross-sectional and descriptive study, a retrospective examination was made of the electronic and physical patient files of patients aged 65 years and older who presented at the Emergency Department of Blacksea Tecnical Univercity Medical Faculty Farabi Hospital between 2019 and 2020.
RESULTS: Of the 647 patients who presented because of trauma, 384 (59.4%) were male and 263 (40.6%) were female. The leading cause of trauma was a same-level fall in 244 (37.7%) cases, followed by piercing or cutting injuries in 123 (19.0%), and a fall from height in 80 (12.4%) cases. Same-level falls and burns injuries were determined at a statistically significantly higher rate in females (p<0.001).
CONCLUSION: Abuse of the elderly and the mechanisms of all traumas, primarily falls as the most common cause of geriatric trauma, are a subject that should be addressed in terms of forensic medicine. Preventative measures against trauma should be implemented and reviewed for the elderly, and health-care personnel should take responsibility for the legal reporting of forensic traumatic injuries.

Travmatik yaralanmalý geriatrik olgularýn medikolegal yönden deðerlendirilmesi

AMAÇ: Dünya genelinde sayýca artýþ gösteren 65 yaþ üzeri, travmatik yaralanmalarýn morbidite ve mortalitesi diðer yaþ gruplarýna göre daha yüksektir. Çalýþmamýzda, 65 yaþ ve üzeri olgularý, cinsiyet, yaþ, travma öyküsü, travmatik yaralanmanýn türü, yaralanma sonrasý klinik progres, yaþlý istismarý ve kiþinin yaþadýðý ortam bakýmýndan inceleyerek, travma sonucu yaralanmalarýn morbidite ve mortalite düzeyleri ile yaþlý istismarý gibi medikolegal yönleriyle irdelemek amaçlanmaktadýr.
GEREÇ VE YÖNTEM: Araþtýrmanýn yapýsý kesitsel tanýmlayýcý bir çalýþma niteliðinde olup, Karadeniz Teknik Üniversitesi Týp Fakültesi Farabi Hastanesi Acil Sevisi’ne 2019–2020 yýllarý arasýnda baþvuru yapmýþ 65 yaþ ve üzeri hasta dosyalarýnýn elektronik ve fiziki ortamda geriye dönük olarak incelenmesi ile yapýlmýþtýr.
BULGULAR: Travma nedeniyle baþvuran 647 hastadan 384 hastanýn (%59.4) erkek, 263 hastanýn (%40.6) kadýn olduðu görüldü. Travma oluþ þekillerinde; 244 (%37.7) olgu ile kendi seviyesinden düþme ilk sýrada görülürken, delici kesici alet yaralanmasý 123 (%19.0) ve yüksekten düþme 80 (%12.4) olgu ile takip etti. Kendi seviyesinden düþme ve yanýk kadýn cinsiyette istatistiksel olarak anlamlý yüksek saptandý (p<0.001).
TARTIÞMA: Geriatrik travmanýn en sýk nedeni olan düþmeler baþta olmak üzere tüm travma oluþ mekanizmalarý ve yaþlý istismarý, adli týbbi açýdan ele alýnmasý gereken bir konudur. Travmayý önleyici tedbirler yaþlýlar için düzenlenmeli ve gözden geçirilmeli, adli travmatik yaralanmalarda saðlýk personeli adli bildirim yükümlülüðünü yerine getirmelidir.