Aggressive operative treatment of isolated blunt traumatic brain injury in the elderly is associated with favourable outcome. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Wutzler, Sebastian; Lefering, Rolf; Wafaisade, Arasch; Maegele, Marc; Lustenberger, Thomas; Walcher, Felix; Marzi, Ingo; Laurer, Helmut; the TraumaRegister DGU, Committee on Emergency Medicine, Intensive Care and Trauma Management of the German Trauma Society (Sektion NIS)
• Is Part Of: Injury. Volume 46:Issue 9(2015)
• Page Start: 1706
• Page End: 1711
• Publication Date: 2015-09
• Subjects: Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2015.02.013
• Languages: English
• ISSNs: 0020-1383

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <p id="spar0005">Outcome after traumatic brain injury (TBI) in the elderly has not been fully elucidated. The present retrospective observational study investigates the age-dependent outcome of patients suffering from severe isolated TBI with regard to operative and non-operative treatment. Data were prospectively collected in the TraumaRegister DGU<sup>®</sup>. Anonymous datasets of 8629 patients with isolated severe blunt TBI (AIS<sub>Head</sub> ≥ 3, AIS<sub>Body</sub> ≤ 1) documented from 2002 to 2011 were analysed. Patients were grouped according to age: 1–17, 18–59, 60–69, 70–79 and ≥80 years. Cranial fractures (44.8%) and subdural haematomas (42.6%) were the most common TBIs. Independent from the type of TBI the group of patients with operative treatment declined with rising age. Subgroup analysis of patients with critical TBI (AIS<sub>Head</sub> = 5) revealed standardised mortality ratios (SMRs) of 0.81 (95% CI 0.75–0.87) in case of operative treatment (<italic>n</italic> = 1201) and 1.13 (95% CI 1.09–1.18) in case of non-operative treatment (<italic>n</italic> = 1096). All age groups ≥60 years showed significantly reduced SMRs in case of operative treatment. Across all age groups the group of patients with low/moderate disability according to the GOS (4 or 5 points) was higher in case of operative treatment. Results of this retrospective observational study have to be interpreted cautiously. However, good outcome after TBI with severe space-occupying haemorrhage is more frequent in patients with operative treatment across all age groups. Age alone should not be the reason for limited care or denial of operative intervention.</p> </sec> </abstract>