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Citation
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Shibahashi K, Hoda H, Ishida T, Sugiyama K, Okura Y, Hamabe Y. World Neurosurg. 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Despite the increasing numbers of older adults with traumatic brain injury (TBI), minimal data supports development of treatment strategies. We aimed to comprehensively describe the incidence, characteristics, outcomes, and predictive accuracy of severity indicators among older adults with TBI.
METHODS: Using the Japan Trauma Data Bank, we identified patients aged ≥18 years with TBI between 2004 and 2019. Patients were grouped according to age, and their baseline characteristics, radiological findings, severity, complications, and in-hospital mortality were assessed. Receiver operating characteristic curves were used to assess the accuracy of severity indicators for predicting in-hospital mortality.
RESULTS: Of 94,180 patients who met the inclusion criteria, 50,990 (54.1%) were older adults (aged ≥65 years). Their proportion increased at 2.1% per year, which exceeded the 0.5% annual increase in the general population. The proportion of females and prevalence of comorbidities significantly increased with age. Traffic accidents were the leading cause of TBI among young adults, while falling at ground level was in those aged ≥75 years. Radiological findings were significantly different between age groups; the proportions of acute epidural hemorrhage, skull fracture, and diffuse axonal injury decreased, whereas that of acute subdural hemorrhage increased with age. The predictive accuracy of the Glasgow Coma Scale, Revised Trauma Score, and Injury Severity Score decreased with age.
CONCLUSIONS: The proportion of older patients with TBI increased faster than the proportion of older people in the general population. Characteristics and predictive accuracy of severity indicators significantly differed among different ages. TBI studies that focus on older patients are necessary.
Language: en |