Poor outcome in frail elderly patient after severe TBI. (29th July 2022)

• Record Type: Journal Article
• Authors: Herklots, Martin W; Kroon, Michael; Roks, Gerwin; Oldenbeuving, Annemarie; Schoonman, Guus G
• Is Part Of: Brain injury. Volume 36:Number 9(2022)
• Page Start: 1118
• Page End: 1122
• Publication Date: 2022-07-29
• Subjects: TBI -- severe TBI -- frailty -- elderly -- trauma mechanism; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2022.2109731
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective: To investigate the influence of frailty in elderly with severe TBI on mortality and functional outcome. Method: 126 patients with TBI aged 60 years or older and with a presenting Glasgow Coma Scale score of 8 or lower were retrospectively included. To investigate frailty, we used the CSHA Clinical Frailty Scale. The primary outcome measures were mortality, and the secondary outcome measures were Glasgow Outcome Scale Extended (GOSE) at discharge and GOSE at 6 months after trauma. Results: High frailty was a significant predictor for mortality (OR 2.38, p 0.047), if adjusted for the injury severity scale. High frailty was also a significant predictor for poor functional outcome after 6 months (OR 4.35, p 0.03). After 6 months, the GOSE of the low frailty group was significantly higher than in the high frailty group (p 0.019). Also, the improvement of the GOSE was significant in the low frailty group (p 0.007), while in the high frailty group there was no significant improvement of the GOSE (p 0.546) after 6 months. Conclusion: Frailty has a significant impact on outcome in elderly with severe TBI. There is a higher mortality in the frail elderly and there is less recovery after TBI.