**4.1. Preexisting medical conditions**

Elderly individuals are more likely to have preexisting comorbidities. The presence of a preexisting medical condition was associated with increase in mortality of elderly patients who sustained low or moderate severity trauma [50]. The most frequent preinjury comorbidities are hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD) and use of anticoagulants/antiplatelets [51]. Preinjury medical conditions usually make the management of geriatric trauma patients challenging; preexisting HT can hide the early signs of shock and cause delay or under-treatment and the presence of heart failure may cause volume overload and pulmonary edema during IV fluid therapy. ET intubation also would be challenging in the patient who has cervical or temporomandibular arthritis. Thus, early detection of preexisting medical conditions, appropriate treatment and follow-up care may improve outcomes following trauma in elderly.
