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Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis

INTRODUCTION: The continuing-to-grow number of older adults with traumatic brain injury (TBI) presenting to emergency departments (EDs) and hospitals necessitates the investigation of TBI in these patients. OBJECTIVE: The present study was conducted to investigate the epidemiology of TBI and the fac...

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Autores principales: Heydari, Farhad, Golban, Mohammad, Majidinejad, Saeed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163265/
https://www.ncbi.nlm.nih.gov/pubmed/32322787
http://dx.doi.org/10.22114/ajem.v0i0.170
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author Heydari, Farhad
Golban, Mohammad
Majidinejad, Saeed
author_facet Heydari, Farhad
Golban, Mohammad
Majidinejad, Saeed
author_sort Heydari, Farhad
collection PubMed
description INTRODUCTION: The continuing-to-grow number of older adults with traumatic brain injury (TBI) presenting to emergency departments (EDs) and hospitals necessitates the investigation of TBI in these patients. OBJECTIVE: The present study was conducted to investigate the epidemiology of TBI and the factors affecting intracranial lesions and patient outcomes in older adults. METHOD: The present retrospective cross-sectional study was performed between March 2016 and March 2018. The study population comprised all TBI patients with a minimum age of 60 years presenting to the ED. The eligible candidates consisted of patients presenting to the ED within 24 hours of the occurrence of traumas and requiring head CT scan as part of their examination. The patients’ baseline information was also recorded. RESULTS: A total of 306 older adult patients with a mean age of 70.61±8.63 years, of whom 67.6% were male, underwent CT scan for TBI during the study period. Falls were the major cause of head injuries, and intracranial lesions were observed in 22.9% (n=70) of the patients. Subdural hematoma (SDH) was observed as the most prevalent injury in 27.6% of the patients, 22.9% (n=16) were transferred to the operating room, and 7.5% (n=23) died. Moreover, the severity of trauma was significantly different between the two genders (P=0.029). Midline shift, SDH, subarachnoid hemorrhage (SAH) and moderate-to-severe head injuries were also significantly associated with poor outcomes (P<0.05). CONCLUSION: Death from TBIs was more likely in the patients with SDH, SAH and midline shift or in those with an initial Glasgow coma scale (GCS) of below 13. These predictions are clinically relevant, and can help improve the management of older adults with TBI.
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spelling pubmed-71632652020-04-22 Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis Heydari, Farhad Golban, Mohammad Majidinejad, Saeed Adv J Emerg Med Original Article INTRODUCTION: The continuing-to-grow number of older adults with traumatic brain injury (TBI) presenting to emergency departments (EDs) and hospitals necessitates the investigation of TBI in these patients. OBJECTIVE: The present study was conducted to investigate the epidemiology of TBI and the factors affecting intracranial lesions and patient outcomes in older adults. METHOD: The present retrospective cross-sectional study was performed between March 2016 and March 2018. The study population comprised all TBI patients with a minimum age of 60 years presenting to the ED. The eligible candidates consisted of patients presenting to the ED within 24 hours of the occurrence of traumas and requiring head CT scan as part of their examination. The patients’ baseline information was also recorded. RESULTS: A total of 306 older adult patients with a mean age of 70.61±8.63 years, of whom 67.6% were male, underwent CT scan for TBI during the study period. Falls were the major cause of head injuries, and intracranial lesions were observed in 22.9% (n=70) of the patients. Subdural hematoma (SDH) was observed as the most prevalent injury in 27.6% of the patients, 22.9% (n=16) were transferred to the operating room, and 7.5% (n=23) died. Moreover, the severity of trauma was significantly different between the two genders (P=0.029). Midline shift, SDH, subarachnoid hemorrhage (SAH) and moderate-to-severe head injuries were also significantly associated with poor outcomes (P<0.05). CONCLUSION: Death from TBIs was more likely in the patients with SDH, SAH and midline shift or in those with an initial Glasgow coma scale (GCS) of below 13. These predictions are clinically relevant, and can help improve the management of older adults with TBI. Tehran University of Medical Sciences 2019-08-15 /pmc/articles/PMC7163265/ /pubmed/32322787 http://dx.doi.org/10.22114/ajem.v0i0.170 Text en © 2020 Tehran University of Medical Sciences http://creativecommons.org/licences/by-nc/4.0/ This open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 License (CC BY-NC 4.0).
spellingShingle Original Article
Heydari, Farhad
Golban, Mohammad
Majidinejad, Saeed
Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title_full Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title_fullStr Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title_full_unstemmed Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title_short Traumatic Brain Injury in Older Adults Presenting to the Emergency Department: Epidemiology, Outcomes and Risk Factors Predicting the Prognosis
title_sort traumatic brain injury in older adults presenting to the emergency department: epidemiology, outcomes and risk factors predicting the prognosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163265/
https://www.ncbi.nlm.nih.gov/pubmed/32322787
http://dx.doi.org/10.22114/ajem.v0i0.170
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