HMCA collaboration between the Trauma Unit in Hamad Medical Corporation (HMC) and the Department of Geriatrics and Long-Term Care, has led to the establishment of a Geriatric Trauma Care Program that facilitates the pro-active triaging of all trauma patients aged 65 and above. The aim is to identify patients that should undergo a Comprehensive Geriatric Assessment (CGA) and enable faster age-appropriate care.

Dr Hanadi Al Hamad

The impetus for the programme came from Dr Hanadi Al Hamad, National Lead for Healthy Ageing in Qatar, Chair of the Geriatric and Long-Term Care Department, and Medical Director of Rumailah Hospital and Qatar Rehabilitation Institute, following evidence of a need for specialised care to be offered to older patients who have been admitted to the trauma unit. On average, the Trauma Unit sees approximately two to three geriatric patients every week. Dr Al Hamad explained:

As patients age, they do not have the same resources or reserves as younger people, and evidence has shown that geriatric patients have unique vulnerabilities in acute illness or trauma. Research indicates that geriatric trauma patients are more likely to sustain significant injuries, even with lower forces of injury, and are therefore served better when they receive specialized age-appropriate care that takes into account various geriatric syndromes that impact on their ability to respond to treatment.

Evidence has shown that 80% of geriatric trauma patients have at least one or more chronic diseases, such as hypertension, arthritis, heart disease, pulmonary disease, cancer, diabetes, or history of stroke. When combined with the altered physiology of increased age described later, these illnesses make geriatric trauma patients less able to tolerate the stress of trauma.

Dr Jorge Passarelli,  Consultant in Ortho Geriatrics/Trauma Geriatrics at HMC explained that geriatric patients may experience a range of factors that impact their ability to recover from trauma.

Geriatric trauma patients often experience decreased vision and hearing, have decreased muscle mass and/or strength, reduced bone mineral density and poor balance and impaired motor function leading to falls. In addition, they may have impaired cognitive function and are more likely to experience delirium and are at higher risk of adverse drug events.

Dr Amir Ibrahim Abdalla, Consultant Geriatrician and Director of Acute Geriatrics in the Department of Geriatrics and Long-Term Care, has been a strong supporter of the programme.

The program was initiated in January this year and so far we have had very favorable feedback from all parties, including our geriatric patients, their families and colleagues in the Trauma unit who have welcomed the specialist support from our department.

Common reasons for trauma in elderly patients include falls from standing height or from a wheelchair, bed, or commode that may have been brought on by the patient’s physical environment inside or outside the home or as a result of a physiological issue, such as dizziness or frailty. Motor vehicle crashes are also among the typical reasons for geriatric patients’ admittance to the Trauma Intensive Care Unit (TICU).

Dr Jorge Passarelli and Dr Gustav Strandvik

Dr Gustav Strandvik, Senior Consultant and Co-Lead Trauma of the Intensive Care Unit (TICU) at Hamad General Hospital also expressed his appreciation of the collaboration with the Geriatrics team that has resulted in this programme offering valuable benefit to older more vulnerable patients.

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