Abstract
[Background] In elderly severe-trauma patients, physiological abnormality is not easily identified during primary examination. Cases of mortality due to delayed diagnosis of bleeding site have been reported. The purpose of this study was to compare massive bleeding sites in younger and elderly severe trauma patients. [Material and Methods] We retrospectively reviewed a total of 76 cases of massive bleeding that were admitted to our institution between September 2006 and December 2013. Massive bleeding was defined as bleeding requiring transfusion of red cell concentrates of more than 10 units within 24 hours after admission or as early death due to massive bleeding. [Result] There were 35 younger patients and 41 older one. The proportions of non-diagnosable cases in primary surveys (massive bleeding due to multiple-site damage caused by a bone fracture and contusion, retroperitoneal hematoma without a pelvic ring fracture and with a stable pelvic ring fracture) were 16% in younger patients and 39% in older patients, with a significant difference between them (P<0.05). [Conclusion] Even if no abnormality is observed during the primary survey in elderly severe-trauma patients, massive bleeding should be considered and treated immediately once diagnosis is confirmed.
