OPTIMIZING OUTCOMES IN GERIATRIC BLUNT THORACIC TRAUMA: INSIGHTS FROM A MULTIDISCIPLINARY NON-OPERATIVE APPROACH – A CASE REPORT

Abstract

Blunt thoracic trauma significantly contributes to morbidity and mortality among the geriatric population, often arising from falls or motor vehicle accidents. These demographic faces unique challenges due to age related physiological changes and comorbidities. This report describes a case of a 71-year-old male pedestrian who sustained blunt thoracic trauma after being struck by a vehicle. The patient initially received care at a local clinic but developed worsening chest pain and shortness of breath within 24 hours. A chest X-ray revealed a right pneumothorax and extensive subcutaneous emphysema, while computed tomography confirmed multiple rib fractures, a flail chest, pneumomediastinum, and bilateral lung contusions. The patient required intubation due to severe respiratory distress and was subsequently admitted to the intensive care unit. Management involved a multidisciplinary approach focusing on pain optimization and aggressive chest physiotherapy. Unfortunately, the patient developed ventilator-associated pneumonia two days after extubating, necessitating re-intubation and tracheostomy. The patient was discharged in stable condition on day 26 post-trauma. This case highlights the complexities of managing blunt thoracic trauma in elderly patients and underscores the critical role of a multidisciplinary approach. Timely imaging, early ICU support, and a multidisciplinary care strategy are critical for optimizing outcomes in elderly patients with severe thoracic trauma, especially those complicated by flail chest and pulmonary contusions.  Given the significant risks associated with surgical procedures in elderly patients, the non-operative approach emerges as the preferred strategy for managing geriatric chest trauma.