# Evaluation of geriatric head and neck trauma cases in a German highest-level trauma centre from 2018 to 2024

## TL;DR

This study examines trends in head and neck injuries among elderly patients in Germany, highlighting the impact of aging, the pandemic, and the high prevalence of comorbidities and anticoagulant use.

## Contribution

The study provides detailed insights into geriatric head and neck trauma patterns, including gender-specific trends and the influence of the SARS-CoV-2 pandemic.

## Key findings

- Falls caused 82% of injuries, with midface fractures and cerebral injuries being common.
- Males were disproportionately affected during the pandemic, with significant volatility in case numbers.
- High rates of comorbidities and anticoagulant use were observed in elderly trauma patients.

## Abstract

Geriatric populations face heightened vulnerability due to aging, socioeconomic challenges, and marginalization. In 2023, 18.1% of Germans over 65 were at risk of poverty, with women and those aged 80 + disproportionately affected. The SARS-CoV-2 pandemic (2020–2022) exacerbated these issues, restricting healthcare access. This study investigates geriatric head and neck trauma trends (2018–2024) across pre-pandemic, pandemic, and post-pandemic periods.

Conducted at a level 1 trauma centre, data were sourced from the Dortmund Maxillofacial Trauma Registry (14,500 + cases, 2007–2024). Fractures were categorized per AO guidelines, and demographic analyses, fracture distribution and other medical conditions were presented.

This study analysed 973 geriatric head and neck trauma cases (2018–2024). Falls were predominant (82.6%), with significant comorbidities (2.6 per patient), including hypertension (64%). Males experienced a 73% decrease in case numbers in 2021. Injuries primarily affected the midface, with 52% requiring surgery. Pandemic disruptions influenced trends, highlighting geriatric trauma complexity and care demands are detailed analysed.

Our study presents comprehensive data on geriatric head and neck traumatology, analyzing 65–75 y.o. and > 75 y.o. groups. Male predominance was significant at 65–70 y.o. (p < 0.001) but reversed above 75 y.o., with significant female dominance. Since the SARS-CoV-2 pandemic, case numbers showed extreme volatility, with a 30% rise in females and 90% in males in 2021, followed by a record low in 2022. Cerebral injuries occurred in 49.3% of patients, with 2.6 comorbidities per capita and 52% requiring surgery. Anticoagulant therapy was frequent (≈ 74% antiplatelet, 26% anticoagulant). Falls caused 82% of injuries, predominantly affecting the nasal bone, zygomatic bone (218), and orbital floor (262), indicating high vulnerability in this population.

Our study reveals volatility in case numbers post-SARS-CoV-2, with males disproportionately affected. A high proportion of elderly patients take anticoagulants. Among the injured, there is a high rate with cerebral injury. Most fractures occur in exposed facial regions. Ongoing surveillance is essential to address increasing geriatric vulnerability.