Elderly pedestrian neurotrauma: A descriptive study from a premier neurotrauma center in India

CONTEXT: Experience with elderly pedestrian neurotrauma at a major neurotrauma tertiary center. AIMS: To highlight the specific injuries and outcome of the elderly pedestrian neurotrauma patients within the city of Bangalore and its surrounding districts. SETTINGS AND DESIGN: A retrospective study consisting of demographic data, clinical findings, radiological details, and outcomes. MATERIALS AND METHODS: A study was conducted at the casualty services, in which 143 consecutive elderly pedestrian (age >60 years) head injury victims were studied from June to September 2009. The records from the hospital mortuary were analyzed from 2007 to 2009. An analysis of 77 elderly patients who died as a pedestrian in accidents during this period was performed. STATISTICAL ANALYSIS USED: SPSS 15. RESULTS: The elderly pedestrians constituted 27% (143/529) of all pedestrian traumas. Two wheelers were the most common accident vehicle (56.6%, 81/143). Most of the injuries (38.5%, 55/143) occurred during peak traffic hours, that is, 4 pm to 9 pm. Majority sustained moderate to severe head injury (61%, 87/143). More than three-fourths of patients required a computed tomography (CT) scan (77%, 110/143), in which there was a higher frequency of contusion (31.5%, 45/143), and subdural hemorrhage (23.1%, 33/143). Most of the injured (43.3%, 13/30) underwent surgery for intracranial hematoma. The mortality rate was 22.8% (8/35). Nearly one-fourth of conducted postmortems among pedestrians belonged to the elderly age group (77/326, 23.6%). CONCLUSIONS: Elderly pedestrian neurotrauma patients sustain a more severe injury as evident by poorer Glasgow Coma Score (GCS) scores and CT scan findings, and hence have a higher mortality rate.