Non-Trauma Related Complications and Co-Morbidities
A premorbid condition is any preexisting condition that a person may have prior to experiencing a traumatic event. In other words, it is a condition that was already affecting a patient before his or her arrival to the trauma unit. A premorbid condition influences how well a patient will react to a traumatic injury and can influence how a doctor will care for an injured patient.
To better understand the significance of premorbid conditions and how they can affect a patient, it is very important to understand the concept of physiologic reserve.
Physiologic reserve is a measure of the body’s ability to heal itself. Premorbid conditions directly determine a person’s physiologic reserve. Prior to injury, a person’s physiologic reserve can be determined by looking at multiple factors, such as age, gender, and preexisting diseases. For example, just as an 80-year-old with heart disease will have more trouble walking up five flights of stairs compared to a healthy 20-year-old marathon runner, older patients have more trouble and greater complications in recovering from a traumatic injury. This is because an older person will have less initial physiologic reserve than a younger person. At the time of injury, patients begin to consume their reserve in an attempt to sustain normal function and heal their injuries. Patients with massive injury consume physiologic reserve faster than patients with less severe injury. As time progresses, physiologic reserve may deteriorate as the patient’s body attempts to heal the injuries.