Isolated traumatic brain injury: age is an independent predictor of mortality and early outcome.
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 > or = 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 > or = 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.


CONCLUSIONS
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.
Mosenthal
Anne C
AC
Department of Surgery, New Jersey Medical School, Newark, New Jersey 07103, USA. mosentac@umdnj.edu
Lavery
Robert F
RF
Addis
Michael
M
Kaul
Sanjeev
S
Ross
Steven
S
Marburger
Robert
R
Deitch
Edwin A
EA
Livingston
David H
DH
D000328:Adult; D000367:Age Factors; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000401:mortality* / Q000628:therapy; D005260:Female; D023261:Glasgow Outcome Scale; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors