Lara A Harvey1, Jacqueline C T Close. 1. Falls and Injury Prevention Group, Neuroscience Research Australia, University of New South Wales, Australia. l.harvey@neura.edu.au
Abstract
INTRODUCTION: Traumatic brain injury is of particular concern in the older population. We aimed to examine the trends in hospitalisations, causes and consequences of TBI in older adults in New South Wales, Australia. METHODS: TBI cases from 1 July 1998 to 30 June 2011 were identified from hospitalisation data for all public and private hospitals in NSW. Direct aged standardised admission rates were calculated. Negative binomial regression modelling was used to examine the statistical significance of changes in trend over time. RESULTS: There were 12,564 hospitalisations for TBI over the 13 year study period. Hospitalisation rates for TBI among the older population increased by 7.2% (95% CI 6.4-8.0, p<.0001) per year from 65.3/100,000 to 151.8/100,000. [corrected]. Males had a consistently higher hospitalisation rate. Just under one third of all hospitalisations were for adults aged 85 years and over. Traumatic subdural haemorrhage (42.9%), concussive injury (24.1%) and traumatic subarachnoid haemorrhage (12.7%) were the most common type of injury. Falls were the most common cause of TBI (82.9%). Rates of fall-related TBI increased by 8.4% (95% CI 7.5-9.3, p<.001) per year, whilst non-fall related head injury increased by 2.1% (95% CI 0.9-3.3, p<.0001) per year. The majority of falls were as a result of a fall on the same level and occurred at home. 13% of hospitalisations resulted in death, and the majority occurred in those who sustained a traumatic subdural haemorrhage. CONCLUSIONS: The rapid increase in hospitalised TBI is being predominantly driven by falls in the oldest old and the greatest increase predominantly in intracranial haemorrhages, highlighting the need for future research to quantify the risk versus benefit of anticoagulant therapies.
INTRODUCTION:Traumatic brain injury is of particular concern in the older population. We aimed to examine the trends in hospitalisations, causes and consequences of TBI in older adults in New South Wales, Australia. METHODS:TBI cases from 1 July 1998 to 30 June 2011 were identified from hospitalisation data for all public and private hospitals in NSW. Direct aged standardised admission rates were calculated. Negative binomial regression modelling was used to examine the statistical significance of changes in trend over time. RESULTS: There were 12,564 hospitalisations for TBI over the 13 year study period. Hospitalisation rates for TBI among the older population increased by 7.2% (95% CI 6.4-8.0, p<.0001) per year from 65.3/100,000 to 151.8/100,000. [corrected]. Males had a consistently higher hospitalisation rate. Just under one third of all hospitalisations were for adults aged 85 years and over. Traumatic subdural haemorrhage (42.9%), concussive injury (24.1%) and traumatic subarachnoid haemorrhage (12.7%) were the most common type of injury. Falls were the most common cause of TBI (82.9%). Rates of fall-related TBI increased by 8.4% (95% CI 7.5-9.3, p<.001) per year, whilst non-fall related head injury increased by 2.1% (95% CI 0.9-3.3, p<.0001) per year. The majority of falls were as a result of a fall on the same level and occurred at home. 13% of hospitalisations resulted in death, and the majority occurred in those who sustained a traumatic subdural haemorrhage. CONCLUSIONS: The rapid increase in hospitalised TBI is being predominantly driven by falls in the oldest old and the greatest increase predominantly in intracranial haemorrhages, highlighting the need for future research to quantify the risk versus benefit of anticoagulant therapies.
Authors: Jennifer S Albrecht; Jon Mark Hirshon; Maureen McCunn; Kathleen T Bechtold; Vani Rao; Linda Simoni-Wastila; Gordon S Smith Journal: J Head Trauma Rehabil Date: 2016 Sep-Oct Impact factor: 2.710
Authors: Daniel K Nishijima; Samuel D Gaona; Trent Waechter; Ric Maloney; Adam Blitz; Andrew R Elms; Roel D Farrales; James Montoya; Troy Bair; Calvin Howard; Megan Gilbert; Renee P Trajano; Kaela M Hatchel; Mark Faul; Jeneita M Bell; Victor C Coronado; David R Vinson; Dustin W Ballard; Daniel J Tancredi; Hernando Garzon; Kevin E Mackey; Kiarash Shahlaie; James F Holmes Journal: J Neurotrauma Date: 2018-02-09 Impact factor: 5.269
Authors: Jennifer S Albrecht; Xinggang Liu; Gordon S Smith; Mona Baumgarten; Gail B Rattinger; Steven R Gambert; Patricia Langenberg; Ilene H Zuckerman Journal: J Head Trauma Rehabil Date: 2015 Mar-Apr Impact factor: 2.710