Changing Demographics of the American Population

Geriatric citizens in the United States are the most rapidly growing segment due to the aging baby boomer generation. This generation will live longer than the preceding and will have access to improved health care. Because these physically active elderly will remain living independently and longer, traumatic injuries can be expected to increase. In addition, there are numerous physiologic alterations that occur with aging, and special consideration should be given to the elderly patient from a medical and surgical standpoint. Multiple comorbidities may also be present in this population lending to higher complications, longer hospital stays, and a higher case fatality rate. Moreover, disposition barriers often exist and include the need for short- and long-term rehabilitation. Finally, traumatic injuries have the ability to change the patient’s independent living status and increase the need for admission to skilled nursing facilities. Complex end-of-life decisions and discussions are often also required in this population. Trauma and acute care surgeons should be knowledgeable about the specific needs of the geriatric critically ill patient.