Article ; Online: Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study.
2022 Volume 53, Issue 8, Page(s) 2774–2782
Abstract: Introduction: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an ... ...
| Abstract | Introduction: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. Methods: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. Results: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. Conclusion: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive. |
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| MeSH term(s) | Aged ; Brain Injuries, Traumatic ; Glasgow Outcome Scale ; Humans ; Patient Acceptance of Health Care ; Prospective Studies ; Quality of Life/psychology |
| Language | English |
| Publishing date | 2022-05-26 |
| Publishing country | Netherlands |
| Document type | Journal Article |
| ZDB-ID | 218778-4 |
| ISSN | 1879-0267 ; 0020-1383 |
| ISSN (online) | 1879-0267 |
| ISSN | 0020-1383 |
| DOI | 10.1016/j.injury.2022.05.009 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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