A medicolegal evaluation of geriatric cases with traumatic injuries.

BACKGROUND: The morbidity and mortality of traumatic injuries are higher in individuals aged >65 years, which are a population group showing an increase worldwide, compared to other age groups. The aim of this study was to compare the medicolegal aspects, such as abuse of the elderly with the morbidity and mortality rates of injuries resulting from trauma by examining the age, gender, trauma history, type of traumatic injury, clinical progress following injury, elderly abuse, and the care environment of the person in cases aged 65 years and older. METHODS: In this cross-sectional and descriptive study, a retrospective examination was made of the electronic and physical patient files of patients aged 65 years and older who presented at the Emergency Department of Blacksea Tecnical Univercity Medical Faculty Farabi Hospital between 2019 and 2020. RESULTS: Of the 647 patients who presented because of trauma, 384 (59.4%) were male and 263 (40.6%) were female. The leading cause of trauma was a same-level fall in 244 (37.7%) cases, followed by piercing or cutting injuries in 123 (19.0%), and a fall from height in 80 (12.4%) cases. Same-level falls and burns injuries were determined at a statistically significantly higher rate in females (p<0.001). CONCLUSION: Abuse of the elderly and the mechanisms of all traumas, primarily falls as the most common cause of geriatric trauma, are a subject that should be addressed in terms of forensic medicine. Preventative measures against trauma should be implemented and reviewed for the elderly, and health-care personnel should take responsibility for the legal reporting of forensic traumatic injuries.

Medicolegal evaluation of cases with burn trauma: Accident or physical abuse.

INTRODUCTION AND OBJECTIVE: Burns are thermal injuries that may have a wide variety of clinical consequences from simple injuries to mortality. There are many aspects that must be medicolegally addressed in both non-survivors and survivors from burn injuries. The objective of this study was to determine sociodemographic characteristics, injury patterns, treatment requirements and prognoses of patients with burn injuries to evaluate the findings of neglect-abuse and forensic reporting processes. This study also aimed to contribute to the medicolegal classification criteria in respect of the factors that have an effect on the prognosis in the analyses. MATERIAL AND METHOD: The study was conducted by retrospective review of digital files and paper records of patients who received therapy in the Burns Unit of KTU Farabi Hospital between 1st January, 2013, and 31st December, 2017. RESULTS: Evaluation was made of a total of 1225 patients, comprising 769 (62.8%) males and 456 (37.2%) females, with a mean age of 21.8 ± 23.8 years (range, 1-89 years). The mean burnt body surface area was 14.29 ± 13.74. A trauma-related psychiatric disorder was diagnosed in 60 (4.9%) patients during treatment. When the medical history and physical examination findings were evaluated together, burn injuries suggested physical abuse in 54 patients (4.4%). The doctors who evaluated the patients with burn injuries in the emergency room and those who applied treatment in the Burns Unit made a forensic notification for 379 (30.9%) patients. The mean age of non-survivors was significantly higher than that of patients who survived to discharge (56.54 ± 28.60 years for non-survivors and 19.39 ± 23.12 years for survivors; p < 0.001). CONCLUSION: Burn injuries are frequently encountered, and they require precautionary measures. Burn injuries due to abuse are more frequently observed in the elderly and especially in children. Thus, the findings must be correctly interpreted, and more effort should be made to improve the knowledge of healthcare professionals about forensic reporting. Moreover, regulations should be implemented in respect of the medicolegal classification of trauma.