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Acta Neurochirurgica
Published in: Acta Neurochirurgica 1/2016

01-01-2016 | Clinical Article - Brain Injury

Promising clinical outcome of elderly with TBI after modern neurointensive care

Authors: Abraham Merzo, Samuel Lenell, Lena Nyholm, Per Enblad, Anders Lewén

Published in: Acta Neurochirurgica | Issue 1/2016

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Abstract

Background

The increasing number of elderly patients with traumatic brain injury (TBI) leads to specific neurointensive care (NIC) challenges. Therefore, elderly subjects with TBI need to be further studied. In this study we evaluated the demographics, management and outcome of elderly TBI patients receiving modern NIC.

Methods

Patients referred to our NIC unit between 2008 and 2010 were included. Patients were divided in two age groups, elderly (E) ≥65 years and younger (Y) 64–15 years. Parameters studied were the dominant finding on CT scans, neurological motor skills and consciousness, type of monitoring, neurosurgical procedures/treatments and Glasgow Outcome Scale Extended score at 6 months after injury.

Results

Sixty-two E (22 %) and 222 Y (78 %) patients were included. Falls were more common in E (81 %) and vehicle accidents were more common in Y patients (37 %). Acute subdural hematoma was significantly more common in E (50 % of cases) compared to Y patients (18 %). Intracranial pressure was monitored in 44 % of E and 57 % of Y patients. Evacuation of significant mass lesions was performed more common in the E group. The NIC mortality was similar in both groups (4–6 %). Favorable outcome was observed in 72 % of Y and 51 % of E patients. At the time of follow-up 25 % of E and 7 % of Y patients had died.

Conclusions

The outcome of elderly patients with TBI was significantly worse than in younger patients, as expected. However, as much as 51 % of the elderly patients showed a favorable outcome after NIC. We believe that these results encourage modern NIC in elderly patients with TBI. We need to study how secondary brain injury mechanisms differ in the older patients and to identify specific outcome predictors for elderly patients with TBI.
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Metadata
Title
Promising clinical outcome of elderly with TBI after modern neurointensive care
Authors
Abraham Merzo
Samuel Lenell
Lena Nyholm
Per Enblad
Anders Lewén
Publication date
01-01-2016
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-015-2639-6

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