Acute Traumatic Brain Injury: Mortality in the Elderly

World Neurosurgery
Erik HerouGregor Tomasevic

Abstract

Despite recent progress, prognosis for the elderly (defined as aged ≥70 years) afflicted by traumatic brain injury (TBI) is unfavorable and surgical intervention remains controversial. Research during the past decade on the mortality rates or prognostic factors for survival in the elderly is limited. We analyzed 97 patients aged ≥70 years who were treated surgically for closed TBI at our neurosurgical unit between January 1, 2003 and December 31, 2012. In addition, we analyzed 22 patients aged ≥70 years who had sustained a closed TBI and on whom no neurosurgical intervention was performed. Outcome in both groups was measured as 30-, 90- and 180-day mortality. Surgically treated patients: median age, 76 years' 30-day overall mortality rate, 36%. Higher mortality was seen with lower level of consciousness, high energy trauma, one pupil fixed and dilated, and more extensive intracranial pathology. Presence of warfarin, more advanced age, or degree of midline shift were not associated with worsened outcome. Patients not treated neurosurgically: median age. 81.5 years; 30-day overall mortality rate, 23%. Mortality for patients with Glasgow coma scale (GCS) 10-15 was 6%, GCS 6-9 67%, and GCS 3-5 100%. Selected patients aged ≥70 years...Continue Reading

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Citations

Dec 8, 2017·Journal of Neurotrauma·Raquel C GardnerGeoffrey T Manley
Dec 14, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Hedi ChellyMounir Bouaziz
Jun 27, 2018·Journal of Neurotrauma·Lachlan R EvansJin W Tee
Nov 20, 2016·Korean Journal of Neurotrauma·Young Ha JeongUNKNOWN Korean Trauma Data Bank System Committee
Sep 15, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Christopher SperingStephan Sehmisch
Jul 25, 2019·Frontiers in Surgery·Terence Yi Song LiewTseng Tsai Yeo
Feb 5, 2021·Medicina·Mariarosaria AromatarioBenedetta Baldari

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