Michael Rozenfeld1, Adi Givon1, Israeli Trauma Group2, Kobi Peleg1. 1. Israel National Centre for Trauma and Emergency Research, Gertner Institute, Tel Hashomer, Israel. 2. Israeli Trauma Group Includes: Alfici R, Bahouth H, Bala M, Becker A, Jeroukhimov I, Karawani I, Klein Y, Lin G, Merin O, Mnouskin Y, Kessel B, Shaked G, Sivak G, Soffer D, Stein M, and Weiss M.
Abstract
Background: Recent studies noted the limited applicability of Glasgow Coma Scale (GCS) for elderly patients with Traumatic Brain Injury (TBI). However, the dichotomic distinction between "elderly" and "non-elderly" does not cover the full span of influence of age on GCS presentation.Objective: To analyze the influence of age on GCS scores of patients with isolated TBI. Methods: A retrospective study of 18,534 patients hospitalized due to isolated TBI recorded in the Israeli National Trauma Registry in 1997-2017. The GCS scores were compared between four age-groups: 20-44, 45-64, 65-74 and 75+ years old. Additional factors included patient's sex, Abbreviated Injury Scores (AIS) and injury circumstances. Results: GCS scores increased continuously with age at all AIS levels. The trend was significant even after adjustment for patient's sex and injury circumstances. The angle of the trend was different in various injury circumstances, with GCS scores of victims of Road Traffic Accidents sharply increasing after age of 44 and that of the patients hospitalized after falling from own height surging after age of 64.Conclusions: Screening procedures for patients with TBI should give a greater weight to the actual age of adults, as well as to the circumstances of their injury.
Background: Recent studies noted the limited applicability of Glasgow Coma Scale (GCS) for elderly patients with Traumatic Brain Injury (TBI). However, the dichotomic distinction between "elderly" and "non-elderly" does not cover the full span of influence of age on GCS presentation.Objective: To analyze the influence of age on GCS scores of patients with isolated TBI. Methods: A retrospective study of 18,534 patients hospitalized due to isolated TBI recorded in the Israeli National Trauma Registry in 1997-2017. The GCS scores were compared between four age-groups: 20-44, 45-64, 65-74 and 75+ years old. Additional factors included patient's sex, Abbreviated Injury Scores (AIS) and injury circumstances. Results: GCS scores increased continuously with age at all AIS levels. The trend was significant even after adjustment for patient's sex and injury circumstances. The angle of the trend was different in various injury circumstances, with GCS scores of victims of Road Traffic Accidents sharply increasing after age of 44 and that of the patients hospitalized after falling from own height surging after age of 64.Conclusions: Screening procedures for patients with TBI should give a greater weight to the actual age of adults, as well as to the circumstances of their injury.
Entities:
Keywords:
Glasgow Coma Scale; TBI; age; elderly; trauma mechanisms
Authors: Denise Jochems; Eveline van Rein; Menco Niemeijer; Mark van Heijl; Michael A van Es; Tanja Nijboer; Luke P H Leenen; R Marijn Houwert; Karlijn J P van Wessem Journal: Sci Rep Date: 2021-10-07 Impact factor: 4.379