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Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study

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  • Marjolein van der Vlegel
  • Ana Mikolić
  • Quentin Lee Hee
  • Z L Rana Kaplan
  • Isabel R A Retel Helmrich
  • Ernest van Veen
  • Nada Andelic
  • Nicole V Steinbuechel
  • Anne Marie Plass
  • Marina Zeldovich
  • Lindsay Wilson
  • Andrew I R Maas
  • Juanita A Haagsma
  • Suzanne Polinder
  • Cecilia Åkerlund
  • Pradeep George
  • Linda Lanyon
  • Visakh Muraleedharan
  • David Nelson
  • Krisztina Amrein
  • Erzsébet Ezer
  • Noémi Kovács
  • Béla Melegh
  • József Nyirádi
  • Viktória Tamás
  • Zoltán Vámos
  • Abayomi Sorinola
  • Nada Andelic
  • Lasse Andreassen
  • Audny Anke
  • Shirin Frisvold
  • Anna Antoni
  • Elisabeth Schwendenwein
  • Gérard Audibert
  • Philippe Azouvi
  • Maria Luisa Azzolini
  • Luigi Beretta
  • Maria Rosa Calvi
  • Ronald Bartels
  • Hugo den Boogert
  • Pál Barzó
  • Romuald Beauvais
  • Natascha Perera
  • Ronny Beer
  • Raimund Helbok
  • Bo-Michael Bellander
  • Antonio Belli
  • Habib Benali
  • Daniel Kondziella (Medlem af forfattergruppering)
  • Martin Fabricius (Medlem af forfattergruppering)
Vis graf over relationer

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.

Udgave nummer8
Sider (fra-til)2774-2782
Antal sider9
StatusUdgivet - aug. 2022

Bibliografisk note

Copyright © 2022. Published by Elsevier Ltd.

ID: 79412399