Isolated traumatic brain injury; age is an independent predictor of mortality and early outcome

Anne C. Mosenthal, Robert F. Lavery, Michael Addis, Sanjeev Kaul, Steven Ross, Robert Marburger, Edwin A. Deitch, David H. Livingston

Research output: Contribution to journalArticle

223 Citations (Scopus)

Abstract

Background Geriatric trauma patients have a worse outcome than the young with comparable injuries. The contribution of traumatic brain injury (TBI) to this increased mortality is unknown and has been confounded by the presence of other injuries. The purpose of this study was to investigate the role of age in the mortality and early outcome from isolated TBI. Methods This was a retrospective analysis of all adult patients with isolated TBI (Abbreviated Injury Scale score ≥ 3) admitted during a 5-year period to two Level I trauma centers. Mortality, Glasgow Outcome Scale score at discharge, therapy, and complications were compared for elderly (age ≥ 65 years) and younger patients. Results Of 694 patients, 22% were defined as elderly. The mortality for the elderly group was twice that of their younger counterparts (30% vs. 14%, p < 0.001), even for those with mild to moderate TBI (Glasgow Coma Scale score of 9-15). Thirteen percent of elderly survivors had a poor functional outcome (Glasgow Outcome Scale score of 2 or 3) at hospital discharge versus 5% in the young group (p < 0.01). Independent factors associated with a high mortality were age and Glasgow Coma Scale score. Conclusion The mortality from TBI is higher in the geriatric population at all levels of head injury. In addition, functional outcome at hospital discharge is worse. Although some of this increased mortality may be explained by complications or type of head injury, age itself is an independent predictor for mortality in TBI.

Original languageEnglish (US)
Pages (from-to)907-911
Number of pages5
JournalJournal of Trauma
Volume52
Issue number5
DOIs
StatePublished - May 2002

Fingerprint

Mortality
Glasgow Outcome Scale
Glasgow Coma Scale
Craniocerebral Trauma
Geriatrics
Wounds and Injuries
Abbreviated Injury Scale
Traumatic Brain Injury
Trauma Centers
Survivors
Population
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Keywords

  • Elderly
  • Glasgow Outcome Scale
  • Mortality
  • Traumatic brain injury

Cite this

Mosenthal, Anne C. ; Lavery, Robert F. ; Addis, Michael ; Kaul, Sanjeev ; Ross, Steven ; Marburger, Robert ; Deitch, Edwin A. ; Livingston, David H. / Isolated traumatic brain injury; age is an independent predictor of mortality and early outcome. In: Journal of Trauma. 2002 ; Vol. 52, No. 5. pp. 907-911.
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Isolated traumatic brain injury; age is an independent predictor of mortality and early outcome. / Mosenthal, Anne C.; Lavery, Robert F.; Addis, Michael; Kaul, Sanjeev; Ross, Steven; Marburger, Robert; Deitch, Edwin A.; Livingston, David H.

In: Journal of Trauma, Vol. 52, No. 5, 05.2002, p. 907-911.

Research output: Contribution to journalArticle

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T1 - Isolated traumatic brain injury; age is an independent predictor of mortality and early outcome

AU - Mosenthal, Anne C.

AU - Lavery, Robert F.

AU - Addis, Michael

AU - Kaul, Sanjeev

AU - Ross, Steven

AU - Marburger, Robert

AU - Deitch, Edwin A.

AU - Livingston, David H.

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N2 - Background Geriatric trauma patients have a worse outcome than the young with comparable injuries. The contribution of traumatic brain injury (TBI) to this increased mortality is unknown and has been confounded by the presence of other injuries. The purpose of this study was to investigate the role of age in the mortality and early outcome from isolated TBI. Methods This was a retrospective analysis of all adult patients with isolated TBI (Abbreviated Injury Scale score ≥ 3) admitted during a 5-year period to two Level I trauma centers. Mortality, Glasgow Outcome Scale score at discharge, therapy, and complications were compared for elderly (age ≥ 65 years) and younger patients. Results Of 694 patients, 22% were defined as elderly. The mortality for the elderly group was twice that of their younger counterparts (30% vs. 14%, p < 0.001), even for those with mild to moderate TBI (Glasgow Coma Scale score of 9-15). Thirteen percent of elderly survivors had a poor functional outcome (Glasgow Outcome Scale score of 2 or 3) at hospital discharge versus 5% in the young group (p < 0.01). Independent factors associated with a high mortality were age and Glasgow Coma Scale score. Conclusion The mortality from TBI is higher in the geriatric population at all levels of head injury. In addition, functional outcome at hospital discharge is worse. Although some of this increased mortality may be explained by complications or type of head injury, age itself is an independent predictor for mortality in TBI.

AB - Background Geriatric trauma patients have a worse outcome than the young with comparable injuries. The contribution of traumatic brain injury (TBI) to this increased mortality is unknown and has been confounded by the presence of other injuries. The purpose of this study was to investigate the role of age in the mortality and early outcome from isolated TBI. Methods This was a retrospective analysis of all adult patients with isolated TBI (Abbreviated Injury Scale score ≥ 3) admitted during a 5-year period to two Level I trauma centers. Mortality, Glasgow Outcome Scale score at discharge, therapy, and complications were compared for elderly (age ≥ 65 years) and younger patients. Results Of 694 patients, 22% were defined as elderly. The mortality for the elderly group was twice that of their younger counterparts (30% vs. 14%, p < 0.001), even for those with mild to moderate TBI (Glasgow Coma Scale score of 9-15). Thirteen percent of elderly survivors had a poor functional outcome (Glasgow Outcome Scale score of 2 or 3) at hospital discharge versus 5% in the young group (p < 0.01). Independent factors associated with a high mortality were age and Glasgow Coma Scale score. Conclusion The mortality from TBI is higher in the geriatric population at all levels of head injury. In addition, functional outcome at hospital discharge is worse. Although some of this increased mortality may be explained by complications or type of head injury, age itself is an independent predictor for mortality in TBI.

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