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© 1998 Oxford University Press

research-article

Effects of ageing on the initial metabolic response to accidental injury

ROGER N. BARTON, KEITH N. FRAYN1, H. BERRINGTON STONER and RODERICK A. LITTLE

North Western Injury Research Centre, University of Manchester Stopford Building, Oxford Road, Manchester M13 9PT, UK

Address correspondence to R. N. Barton. Fax: (+44)161 275 5190. E-mail: rbarton{at}fsl.scg.man.ac.uk

BACKGROUND:: little is known about the effects of ageing on the early metabolic response to injury. This response is thought to have evolved as a defence mechanism and may be particularly important in old people, who often present late to hospital after accidental injury.

SETTING:: the accident and emergency department of a teaching hospital.

SUBJECTS:: 352 patients studied within 2 h of accidental injury, before the start of definitive treatment.

METHODS:: a single blood sample was taken from each patient and the plasma concentrations of glucose, insulin, lactate, non-esterified fatty acids and cortisol were measured. Factorial analysis of variance was used to distinguish the effects of age (17–40, 41–65 and 66–92 years) from those of Injury Severity Score (1–6, 8–12, 13–24 and 25–66).

RESULTS:: elderly patients had a higher concentration of glucose than young ones. There were no consistent age-effects for the other analytes. Although men were over-represented among the young and women among the elderly, a similar analysis by sex in the 41–65-year-old group suggested that this uneven distribution did not bias the results.

CONCLUSION:: elderly people do not have a defective early biochemical response to injury.

Keywords: aged, glucose, Injury Severity Score, lactates, non-esterified fatty acids

Received January 12, 1998;
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