Citation

Ibañez Pérez De La Blanca MA, Fernández Mondéjar E, Gómez Jimènez FJ, Alonso Morales JM, Lombardo MDQ, Viso Rodriguez JL. Brain Inj. 2018; 32(1): 99-104.

Affiliation

Emergency Unit , Complejo Hospitalario Universitario de Granada , Granada , Spain.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2017.1382716

PMID

29156999

Abstract

PRIMARY OBJECTIVE: To identify risk factors for intracerebral lesion (ICL) in older adults with mild traumatic brain injury (MTBI) and evaluate the influence of comorbidities on outcomes. RESEARCH DESIGN: Prospective cohort study.

METHODS AND PROCEDURES: Information was gathered on clinical history/examination, cranial computed tomography, admission Glasgow Coma Scale (GCS) score, analytical and coagulation findings, and mortality at 1 week post-discharge. Bivariate and multivariate logistic regression analyses were performed, calculating odds ratios for ICL with 95% confidence interval. P < 0.05 was considered significant. MAIN OUTCOMES AND RESULTS: Data were analyzed on 504 patients with mean±SD age of 79.37 ± 8.06 years. Multivariate analysis showed that traffic accident, GCS score of 14/15, transient consciousness loss, nausea, and receipt of antiplatelets were predictors of ICL, while SRRI and/or benzodiazepine intake was a protective factor. A score was assigned to patients by rounding OR values, and a score ≥1 indicated moderate/high risk of ICL.

CONCLUSIONS: MTBI management should be distinct in over-60 year-olds, who may not present typical symptoms, with frequent comorbidities. Knowledge of risk factors for post-MTBI ICL, associated with higher mortality, is important to support clinical decision-making. Further research is warranted to verify our novel finding that benzodiazepines and/or SSRI inhibitors may act as neuroprotectors.

Language: en

Keywords

Score- Traumatic brain injury; neuroprotectors; over 60 years