Citation

van der Vlegel M, Mikolić A, Lee Hee Q, Kaplan ZLR, Retel Helmrich IRA, van Veen E, Andelic N, Steinbuechel NV, Plass AM, Zeldovich M, Wilson L, Maas AIR, Haagsma JA, Polinder S, Åkerlund C, George P, Lanyon L, Muraleedharan V, Nelson D, Amrein K, Ezer E, Kovacs N, Melegh B, Nyirádi J, Tamas V, Vámos Z, Sorinola A, Andelic N, Andreassen L, Anke A, Frisvold S, Antoni A, Schwendenwein E, Audibert G, Azouvi P, Azzolini ML, Beretta L, Calvi MR, Bartels R, Boogert H, Barzo P, Beauvais R, Perera N, Beer R, Helbok R, Bellander BM, Belli A, Benali H, Degos V, Galanaud D, Perlbarg V, Berardino M, Cavallo S, Blaabjerg M, Rosenlund C, Schou RF, Bragge P, Brazinova A, Majdan M, Taylor MS, Zelinkova V, Brinck V, Jarrett M, Brooker J, Donoghue E, Synnot A, Brorsson C, Koskinen LO, Sundström N, Büki A, Czeiter E, Bullinger M, Cabeleira M, Czosnyka M, Dixit A, Ercole A, Koraropoulos E, Menon D, Newcombe V, Richter S, Smielewski P, Stamatakis E, Williams G, Winzeck S, Zeiler FA, Caccioppola A, Calappi E, Carbonara M, Ortolano F, Zoerle T, Stocchetti N, Cameron P, Gantner D, Murray L, Trapani T, Vallance S, Lozano GC, Pomposo I, Castaño-Leon AM, Gómez PA, Lagares A, Chevallard G, Chieregato A, Citerio G, Vargiolu A, Ceyisakar I, Gravesteijn B, Haagsma JA, Huijben J, Lingsma H, Nieboer D, Mikolić A, Polinder S, Sewalt C, Steyerberg EW, Velt K, Voormolen D, Wiegers E, Peul W, van Dijck JTJM, van Essen TA, van Wijk RPJ, Clusmann H, Coburn M, Kowark A, Rossaint R, Coles J, Cooper JD, Correia M, Čovid A, von Steinbüchel N, Curry N, Stanworth S, Dahyot-Fizelier C, Dark P, Johnson F, Dawes H, Esser P, van Heugten C, De Keyser V, Maas AIR, Menovsky T, Van der Steen G, Corte FD, Grossi F, Depreitere B, Đilvesi, Golubovic J, Karan M, Vuleković P, Dreier J, Vajkoczy P, Wolf S, Dulière GL, Maréchal H, Fabricius M, Kondziella D, Feigin VL, Jones K, Ao BT, Theadom A, Foks K, Haitsma I, Volovici V, Furmanov A, Rosenthal G, Gagliardo P, Gao G, Jiang JY, Ghuysen A, Giga L, Valeinis E, Ziverte A, Glocker B, Rueckert D, Gratz J, Gruen RL, Gupta D, Roe C, Helseth E, Roise O, Horton L, Wilson L, Hutchinson PJ, Kolias AG, Jacobs B, van der Naalt J, Jankowski S, Kompanje E, Timmers M, Laureys S, Ledoux D, Misset B, Lecky F, Olubukola O, Lefering R, Schäfer N, Legrand V, Lejeune A, Vega E, Mattern J, Levi L, Lightfoot R, Maegele M, Manara A, Thomas M, Manley G, Martino C, Sakowitz O, Sanchez-Porras R, Younsi A, McMahon C, Negru A, Orešič M, Palotie A, Parizel PM, Payen JF, Persona P, Piippo-Karjalainen A, Pirinen M, Ples H, Posti JP, Puybasset L, Rădoi A, Ragauskas A, Raj R, Rambadagalla M, Rhodes J, Richardson S, Ripatti S, Ročka S, Rosand J, Rosenfeld JV, Rossi S, Rusnak M, Sahuquillo J, Sandor J, Schmidt S, Schoechl H, Schoonman G, Skandsen T, Stevens R, Stewart W, Takala R, Tamosuitis T, Tenovuo O, Tibboel D, Tolias C, Tudora CM, van der Jagt M, Van Hecke W, Van Praag D, Vyvere TV, Verheyden J, Vespa PM, Vik A, Vilcinis R, Wang KKW, Yang Z, Ylen P. Injury 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.injury.2022.05.009

PMID

35725508

Abstract

INTRODUCTION: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI.

METHODS: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury.

RESULTS: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms.

CONCLUSION: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.

Language: en

Keywords

Outcomes; Mental health; Traumatic Brain Injury; Older adults; Health care utilization; Health-related quality of life