Polytrauma in the elderly: who is at risk? A case-control study - Jakob, D. A.; Pulfer, D.; Schaller, T. M.; Hautz, W.; Klukowska-Rotzler, J.; Exadaktylos, A. K.; Muller, M. (BMC Geriatr, 2026)
AIMS OF THE STUDY: The elderly population of developing countries is increasing rapidly. Complicating this demographic development, elderly patients are at high risk for injuries that result in polytrauma and tend to experience worse outcomes when such injuries occur. The purpose of the present study was to evaluate and identify risk factors for polytrauma in the elderly population (>/= 65 years). METHODS: The following case-control study used the Trauma Registry Database of the University Hospital Bern to extract the case group, consisting of elderly polytrauma patients (ISS >/= 16). The control group, representing an average elderly population in Switzerland, included relatives (>/= 65 years) accompanying patients admitted to the emergency department (ED) of Bern University Hospital. The two groups were compared according to potential risk factors for polytrauma (demographics, civil status, pre-existing conditions, medication use, and care-dependency in daily life). Adjusted odds ratios (OR) were obtained with multivariable regression analyses to identify independent risk factors associated with polytrauma in the elderly people. RESULTS: The study population comprised 400 individuals, including 200 elderly polytrauma patients and 200 age- and sex-matched controls. In univariable conditional logistic regression analysis being married (OR: 0.27, 95% CI: 0.17-0.45), independence from care in daily life (OR: 0.02, 95% CI: 0.00-0.16) and independent mobilization (OR: 0.23, 95% CI: 0.09-0.56) were significantly associated with a lower likelihood of sustaining a polytrauma. In contrast, the presence of any pre-existing condition (OR: 4.90, 95% CI: 2.48-9.67) and a higher Charlson Comorbidity Index (OR: 1.43 per point increase, 95% CI: 1.20-1.70) were strongly associated with polytrauma. Similarly, a higher Comorbidity-Polypharmacy Score was significantly linked to increased odds of suffering a polytrauma (OR: 1.16 per point increase, 95% CI: 1.10-1.23). In the main multivariable conditional regression model, being married (OR: 0.21, 95% CI: 0.10-0.45) and independence from care in daily life (OR: 0.01, 95% CI: 0.00-0.09) remained significantly associated with a lower likelihood of sustaining polytrauma. CONCLUSIONS: In the present case-control study, functional independence and being married were significantly associated with lower likelihood of sustaining a polytrauma, whereas comorbidities and polypharmacy were significantly associated with a higher likelihood. These findings support further consideration of geriatric-specific risk assessments to guide prevention and care strategies for this vulnerable population. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-07041-5.
Keywords: journalArticle; Frailty; Injury; Old; Risk factors; Vulnerable; adhere to the Declaration of Helsinki (; and was not financially compensated. Competing interests: The authors declare no; been accepted and approved by the local ethic committee (BE-2022-00668) and; competing interests; consent before any data was collected. Participation in the study was voluntary; https://www.wma.net/policies-post/wma-declaration-of-helsinki/ ). Consent for; publication: All patients of the control group were asked for written informed