Physiologic changes in geriatric trauma patients

Organ system	Changes	Implications
Pulmonary	Decreased vital capacity Decreased forced expiratory volume Smaller alveolar surface area Decreased chest wall compliance	Reduced respiratory reserve
Cardiac	Decreased cardiac output Decreased sensitivity to catecholamines	Reduced cardiac reserve Vital signs may not reflect severity of injury
Renal	Decreased glomerular filtration rate Decreased renal mass	Increased risk of traumatic injury Increased risk of contrast-induced nephropathy Increased susceptibility to fluid overload Reduced clearance of certain medications
Hepatic	Decreased hepatic function	Decreased clearance of certain medications
Gastrointestinal	Diminished pain sensation Increased laxity of abdominal wall musculature	Potential for significant abdominal injury without peritoneal signs
Immune	Impaired immune response	Increased risk of infection
Musculoskeletal	Loss of muscle mass Osteoporosis	Increased risk of fracture
Neurologic	Decreased autoregulatory capability Brain atrophy	Increased susceptibility to injury from decreased cerebral perfusion Increased risk for occult injury

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