Higher mortality rates among the elderly with mild traumatic brain injury: a nationwide cohort study.
BACKGROUND
It is known that the risk of death in elderly patients with moderate to severe traumatic brain injury is increased. However, the relationship between mild traumatic brain injury and death has never been established. We investigated the mortality rates of older patients with mild traumatic brain injury in Taiwan to evaluate if there is a higher risk of death compared with the general population.


METHODS
We utilized a sampled National Health Insurance claims database containing one million beneficiaries. We followed all adult beneficiaries older than 65 years from January 1, 2005 till December 31, 2009 to see if they died. We further identified patients with mild traumatic brain injury and compared their risk of death with the general population.


RESULTS
We identified 5997 patients with mild traumatic brain injury and 84,117 patients without mild traumatic brain injury. After controlling for age, gender, urbanization level, socioeconomic status, diabetes, hypertension, history of alcohol intoxication, history of ischemic stroke, history of intracranial hemorrhage, malignancies, dementia and Charlson Comorbidity Index score, the adjusted hazard ratio was 1.25 (95% confidence interval, 1.16-1.34).


CONCLUSIONS
Mild traumatic brain injury is an independent significant risk factor for death in the elderly.
Po-Liang
PL
Cheng
Hsin-Yi
HY
Lin
Yi-Kung
YK
Lee
Chen-Yang
CY
Hsu
Ching-Chih
CC
Lee
Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No,2, Minsheng Rd, Dalin Township, Chiayi County 622, Taiwan. drsu119@gmail.com.
Yung-Cheng
YC
Su
D000368:Aged; D001930:Brain Injuries / Q000175:diagnosis / Q000453:epidemiology*; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed