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. 2018 Nov 3;13(1):277.
doi: 10.1186/s13018-018-0975-y.

Risk factors predicting prognosis and outcome of elderly patients with isolated traumatic brain injury

Roman C Ostermann  1   2 , Julian Joestl  3 , Thomas M Tiefenboeck  3 , Nikolaus Lang  3 , Patrick Platzer  3   4 , Marcus Hofbauer  3
Affiliations

Risk factors predicting prognosis and outcome of elderly patients with isolated traumatic brain injury

Roman C Ostermann et al. J Orthop Surg Res. .

Abstract

Background: Traumatic brain injury (TBI), particularly in the elderly patient population, is known to be the single largest cause of death and disability worldwide. The purpose of this retrospective study was to evaluate clinical factors predicting poor outcome with special emphasis on the impact of respiratory failure (RF) on mortality in elderly patients with isolated severe TBI.

Methods: All elderly patients (age ≥ 65 years) with isolated severe head injury, admitted to this level I trauma center, during a period of 18 years (from January 1992 to December 2010) were identified from the trauma registry. The medical records were reviewed for demographics, mechanism of injury (MOI), GCS score at admission, RF, pupillary light reflex (LR), CT findings (subdural hematoma, subarachnoid hematoma, edema, midline-shift), and whether there was conservative treatment or surgical intervention and the Glasgow Outcome Score (GOS) at hospital discharge. Stepwise logistic regression analysis was used to identify risk factors for a poor prognosis and outcome.

Results: The following variables influenced the mortality: respiratory failure, pupillary response, and the injury severity score (ISS). A significant increased risk of death was also found for patients with a midline shift of over 15 mm.

Conclusions: The present study predicts a strong correlation between respiratory failure, pathological pupillary response, a higher ISS, and substantial midline shift with poor outcomes in elderly patients sustaining an isolated severe TBI.

Trial registration: Clinical trials: ID: NCT02386865 . Registered 12 March 2015-retrospectively registered.

Keywords: Elderly patients; Isolated severe traumatic brain injuries (TBI); Outcome prediction; Respiratory failure.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained prior to study start by the corresponding ethic review board (Ethics committee of the Department of Trauma Surgery, Medical University of Vienna).

Prior to investigation, ethics approval was obtained by the institutional review board. Informed consent was obtained written at follow-up investigation of each patient included.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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