TY - JOUR
TI - Head injury mortality in a geriatric population: Differentiating an
“Edge” age group with better potential for benefit than older
poor-prognosis patients
AU - Bouras, Triantafyllos
AU - Stranjalis, George
AU - Korfias, Stefanos and
AU - Andrianakis, Ilias
AU - Pitaridis, Marianos
AU - Sakas, Damianos E.
JO - Korean Journal of Neurotrauma
PY - 2007
VL - 24
TODO - 8
SP - 1355-1361
PB - MARY ANN LIEBERT INC PUBL
SN - null
TODO - 10.1089/neu.2005.370
TODO - age; geriatric population; head injury; mortality; outcome; traumatic
brain injury
TODO - A comparison of outcomes between different modes of head-injury
treatment in the elderly has important bearing on questions of
cost-effectiveness and medical ethics. Here, we have examined rates of
mortality in elderly head-trauma victims to determine whether it is
valid to differentiate an “edge” age group of younger elderly
patients, 65 -74 years of age, from older elderly patients, considering
possible benefit from intensive treatment and surgical intervention. We
collected data from 1926 cases of head trauma and separated them into
three age groups: 14-64 years, 65 -74 years, and 75 years or older. We
then compared these groups with respect to cause of injury, severity of
injury, and whether or not treatment included either admission to an
Intensive Care Unit (ICU) or surgical intervention. We found that road
traffic accidents were the major cause of head injury in the younger age
group, whereas in the elderly falls predominated. Mortality was higher
in the elderly in all the head injury severity subgroups. Young subjects
with a Glasgow Coma Scale (GCS) score of less than or equal to 8 tended
to benefit from ICU treatment whereas patients 75 and over did not,
regardless of their severity of injury. For these patients who were in
the 65-74 age group, the data suggested that some benefit was likely.
Patients 75 and older were significantly less likely to survive surgical
intervention than younger patients. We conclude that it is valid to
treat patients in the age group 65-74 years as a separate group from
those patients 75 and older. Patients in this younger subset of the
elderly may benefit from ICU treatment or surgical intervention.
However, the patients in our older subset of elderly patients clearly
did not, and they had a significantly higher risk of surgical mortality.
ER -