Carol Hawley1, Magdy Sakr2, Sarah Scapinello3, Jesse Salvo4, Paul Wrenn4. 1. Division of Mental Health and Wellbeing, Warwick Medical School, Coventry, UK. 2. Department of Emergency Medicine, University Hospital Coventry and Warwickshire, Coventry, UK. 3. Warwick Medical School, University of Warwick, Coventry, UK. 4. Department of Emergency Care, University Hospital Coventry and Warwickshire, Coventry, UK.
Abstract
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma. We determined age, gender, mechanism of injury, Injury Severity Score, presenting Glasgow Coma Scale (GCS) and Mayo Score, and the association of outcome (Glasgow Outcome Scale (GOS)) with age and clinical presentation. RESULTS: 4413 patients were admitted with trauma meeting TARN criteria: 1389 were ≥65 years and 45% (624) had TBI. For patients ≥65 years with TBI, mean age was 79 (range 65-99); 56% were men. Falls accounted for 85% of all TBIs. Most TBIs were moderate/severe (80%) by the Mayo criteria. Of the 279 patients with subdural haematoma, 28% had neurosurgery. Most patients survived TBI (78%); 57% had a good outcome on GOS at discharge (not requiring care package). Mortality was associated with increased age (17% in ages 65-74 years, 19% in 75-84 years, 30% in ≥85 years, p=0.03). Outcome was significantly associated with injury severity (p=0.0001). CONCLUSIONS: Patients with TBI represented 45% of all trauma cases meeting TARN inclusion criteria. Falls at home accounted for most TBIs. Most had moderate/severe TBI, yet over half made a good recovery on GOS. Our data indicate that injury prevention initiatives should focus on home safety. Further research is needed to examine rehabilitation and follow-up after hospital discharge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma. We determined age, gender, mechanism of injury, Injury Severity Score, presenting Glasgow Coma Scale (GCS) and Mayo Score, and the association of outcome (Glasgow Outcome Scale (GOS)) with age and clinical presentation. RESULTS: 4413 patients were admitted with trauma meeting TARN criteria: 1389 were ≥65 years and 45% (624) had TBI. For patients ≥65 years with TBI, mean age was 79 (range 65-99); 56% were men. Falls accounted for 85% of all TBIs. Most TBIs were moderate/severe (80%) by the Mayo criteria. Of the 279 patients with subdural haematoma, 28% had neurosurgery. Most patients survived TBI (78%); 57% had a good outcome on GOS at discharge (not requiring care package). Mortality was associated with increased age (17% in ages 65-74 years, 19% in 75-84 years, 30% in ≥85 years, p=0.03). Outcome was significantly associated with injury severity (p=0.0001). CONCLUSIONS:Patients with TBI represented 45% of all trauma cases meeting TARN inclusion criteria. Falls at home accounted for most TBIs. Most had moderate/severe TBI, yet over half made a good recovery on GOS. Our data indicate that injury prevention initiatives should focus on home safety. Further research is needed to examine rehabilitation and follow-up after hospital discharge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: William Beedham; George Peck; Simon E Richardson; Kevin Tsang; Michael Fertleman; David Jh Shipway Journal: Clin Med (Lond) Date: 2019-03 Impact factor: 2.659
Authors: Anar Amgalan; Alexander S Maher; Satyaki Ghosh; Helena C Chui; Paul Bogdan; Andrei Irimia Journal: Geroscience Date: 2022-07-06 Impact factor: 7.713
Authors: Ahmed Kashkoush; Jordan C Petitt; Husayn Ladhani; Vanessa P Ho; Michael L Kelly Journal: World Neurosurg Date: 2021-10-07 Impact factor: 2.104
Authors: Raquel C Gardner; Richard Rubenstein; Kevin K W Wang; Frederick K Korley; John K Yue; Esther L Yuh; Pratik Mukherje; Alex B Valadka; David O Okonkwo; Ramon Diaz-Arrastia; Geoffrey T Manley Journal: J Neurotrauma Date: 2018-06-29 Impact factor: 5.269