OBJECTIVE: To evaluate long-term clinical outcome of elderly patients with severe closed head injuries. DESIGN: Retrospective study. PATIENTS AND METHODS: All patients older than 65 years of age admitted to a regional trauma center with a diagnosis of closed head injury and an admission Glasgow Coma Scale (GCS) score of 8 or less. Using chi 2 analysis, Student's t test, and multiple logistic regression, we correlated age, sex, mechanism of injury, pupillary reactivity, alcohol and drug use, admission GCS score, Injury Severity Score, Revised Trauma Score, heart rate, and blood pressure to the main outcome measures, i.e. long-term functional outcome and mortality. RESULTS: Among 40 elderly patients who met the criteria, 27% were still alive at the end of 38 +/- 3 month follow-up. Eighty-five percent of patients who were discharged from the hospital were still alive long-term, but did not show significant neurologic improvement. In a univariate analysis, GCS and pupillary reactivity were predictive for long-term functional outcome and mortality. In a multivariate analysis, GCS and heart rate were predictive. All patients with an admission GCS score of 3 died in-hospital. All patients with an admission GCS score of 3 to 7 were either deceased or lived in persistent vegetative or dependent functional states. CONCLUSIONS: Elderly patients with severe closed head injuries have high in-hospital mortality. Those who survived the hospital stay had high long-term survival, but did not show significant functional improvement. Prediction of long-term functional status is vital to the trauma care of elderly patients with severe closed head injuries.
OBJECTIVE: To evaluate long-term clinical outcome of elderly patients with severe closed head injuries. DESIGN: Retrospective study. PATIENTS AND METHODS: All patients older than 65 years of age admitted to a regional trauma center with a diagnosis of closed head injury and an admission Glasgow Coma Scale (GCS) score of 8 or less. Using chi 2 analysis, Student's t test, and multiple logistic regression, we correlated age, sex, mechanism of injury, pupillary reactivity, alcohol and drug use, admission GCS score, Injury Severity Score, Revised Trauma Score, heart rate, and blood pressure to the main outcome measures, i.e. long-term functional outcome and mortality. RESULTS: Among 40 elderly patients who met the criteria, 27% were still alive at the end of 38 +/- 3 month follow-up. Eighty-five percent of patients who were discharged from the hospital were still alive long-term, but did not show significant neurologic improvement. In a univariate analysis, GCS and pupillary reactivity were predictive for long-term functional outcome and mortality. In a multivariate analysis, GCS and heart rate were predictive. All patients with an admission GCS score of 3 died in-hospital. All patients with an admission GCS score of 3 to 7 were either deceased or lived in persistent vegetative or dependent functional states. CONCLUSIONS: Elderly patients with severe closed head injuries have high in-hospital mortality. Those who survived the hospital stay had high long-term survival, but did not show significant functional improvement. Prediction of long-term functional status is vital to the trauma care of elderly patients with severe closed head injuries.
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: Hilaire J Thompson; Frederick P Rivara; Gregory J Jurkovich; Jin Wang; Avery B Nathens; Ellen J MacKenzie Journal: Crit Care Med Date: 2008-01 Impact factor: 7.598
Authors: Johanna M M Nijboer; Corry K van der Sluis; Pieter U Dijkstra; Hendrik-Jan Ten Duis Journal: Eur J Trauma Emerg Surg Date: 2008-03-18 Impact factor: 3.693
Authors: Calvin H K Mak; Stephen K H Wong; George K Wong; Stephanie Ng; Kevin K W Wang; Ping Kuen Lam; Wai Sang Poon Journal: Curr Transl Geriatr Exp Gerontol Rep Date: 2012-07-06
Authors: Roman C Ostermann; Julian Joestl; Thomas M Tiefenboeck; Nikolaus Lang; Patrick Platzer; Marcus Hofbauer Journal: J Orthop Surg Res Date: 2018-11-03 Impact factor: 2.359
Authors: Stephen D Dingley; Wayne B Bauerle; Christine Ramirez; Holly Weber; Rebecca Wilde-Onia; Ann-Marie Szoke; Adam Benton; Danielle Frutiger; Alaa-Eldin Mira; William Hoff; Stanislaw P Stawicki Journal: J Emerg Trauma Shock Date: 2022-06-27
Authors: A M K Harmsen; G F Giannakopoulos; M Terra; E S M de Lange de Klerk; F W Bloemers Journal: Eur J Trauma Emerg Surg Date: 2016-09-15 Impact factor: 3.693