Immune Aging and Trauma Outcomes: Admission Inflammatory Profiles Consistent with Immunosenescence Are Associated with Excess One-Year Mortality Despite Similar in-Hospital Mortality in Older Adults with Multisystem Trauma
Biology, cilt.15, sa.14, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 14
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/biology15141151
- Dergi Adı: Biology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Directory of Open Access Journals, Zoological Record, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Anahtar Kelimeler: multisystem trauma, geriatric trauma, immunosenescence, one-year mortality, in-hospital mortality, neutrophil-to-lymphocyte ratio, injury severity score, lymphocyte count, creatinine, hypoalbuminemia
- Atatürk Üniversitesi Adresli: Evet
Özet
Objectives: Aging is associated with immunosenescence, which may alter the physiological response to trauma and influence long-term outcomes. This study aimed to compare clinical and laboratory parameters associated with in-hospital (iHM) and one-year mortality (OYM) between adult and geriatric patients with multisystem trauma and to explore laboratory findings consistent with immunosenescence in geriatric patients. Methods: In this retrospective study, 345 patients with multisystem trauma were categorized into adult (n = 255) and geriatric (n = 90) groups according to age. Clinical characteristics and laboratory parameters obtained at emergency department admission were analyzed in relation to iHM and OYM. Results: Although iHM did not differ significantly between groups (p = 0.764), OYM was significantly higher in the geriatric group (p < 0.001). In adults, iHM was associated with a higher Injury Severity Score (ISS), prolonged intensive care unit (ICU) stay, elevated white blood cell and monocyte counts, and hypoalbuminemia. OYM in adults was further associated with a higher ISS, longer hospital stays, and lower hemoglobin and hematocrit levels. In geriatric patients, iHM was associated with a higher ISS, male sex, high-energy trauma, elevated lymphocyte and creatinine levels, and lower hematological ratios. OYM in the geriatric group was additionally associated with advanced age, major surgical intervention, thrombocytopenia, elevated urea–creatinine levels, hypoalbuminemia, and lower hematological ratios. Conclusions: Despite comparable in-hospital mortality, geriatric patients with multisystem trauma demonstrated significantly higher one-year mortality. The reduced post-traumatic inflammatory response observed in geriatric patients may be indicative of underlying immunosenescence and diminished immune reserve, thus emphasizing the necessity for age-specific prognostic models in trauma care.