Poor prognostic factors in elderly patients aged 75 years old or older with mild traumatic brain injury. (September 2019)

• Record Type: Journal Article
• Authors: Seno, Soichiro; Tomura, Satoshi; Ono, Kenichiro; Tanaka, Yoshihiro; Ikeuchi, Hisashi; Saitoh, Daizoh
• Is Part Of: Journal of clinical neuroscience. Volume 67(2019)
• Page Start: 124
• Page End: 128
• Publication Date: 2019-09
• Subjects: Prognostic factor -- Mild traumatic brain injury -- Elderly patient -- Dementia -- Cancer; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2019.06.007
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Elderlies with mild TBI may recover without consequence or with some disability. All patients are Japanese, and 75 years old or older. Dementia, cancer, and antithrombotic therapy are poor prognostic factors. A further world-wide study is needed to further investigate this issue. Abstract: The incidence of traumatic brain injury (TBI) in elderly patients is increasing. We retrospectively investigated the poor prognostic factors at discharge in elderly patients aged 75 years or older admitted to hospital with mild TBI. We continuously enrolled 83 patients aged 75 years or older with mild TBI, in a private general Japanese hospital. The Glasgow Coma Scale scores on admission were within the range of 13–15. Patients with good recovery or moderate disability were included in the "good outcome" group, and those with severe disability, in a persistent vegetative state, or who died were included in the "poor outcome" group. We performed statistical analyses using 8 parameters. We conducted a univariate analysis on each item. Next, we conducted a logistic regression analysis on variables where the p < 0.20 in the univariate analysis. Elderly patients had a poor prognosis when they had dementia (odds ratio [OR]: 20.357, 95% confidence interval [CI]: 2.075–199.683, p = 0.010), cancer (OR: 14.005, 95% CI: 1.262–154.444, p = 0.032), or a history of antithrombotic therapy before admission (OR: 6.673, 95% CI: 1.072–41.526, p = 0.042). When elderly patients aged 75 years or older with mild TBI have the 3 poor prognostic factors of dementia, cancer, or a history of antithrombotic therapy, their outcomes might be worse compared to other elderly patients. Elderly patients who have these factors should be carefully managed.