Epidemiology and Outcomes of Traumatic Brain Injury in Elderly Population : A Multicenter Analysis Using Korean Neuro-Trauma Data Bank System 2010-2014

Abstract

Objective: Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS).

Methods: The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS.

Results: The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant.

Conclusion: To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.

Keywords: Brain injuries, Traumatic; Elderly; Epidemiology; Korean Neuro-Trauma Data Bank System; Mortality.

Fig. 1.

Incidence of traumatic brain injury in elderly patients according to the age distribution and sex. DSK : Demographic statistics of the Korea National Statistical Office in March 2014, Pts : patients in this study (n=904).

Fig. 2.

Main diagnosis of older patients with traumatic brain injury according to age. A-EDH : acute epidural hematoma, A-SDH : acute subdural hematoma, T-SAH : traumatic subarachnoid hemorrhage, C-ICH : contused intracranial hemorrhage, DAI : diffuse axonal injury.

Fig. 3.

Time interval from traumatic brain injury to arrival for emergency room of hospital.

Fig. 4.

People who provided first aid earliest to patients with traumatic brain injury.

Fig. 5.

Treatment of elderly patients with TBI according to age distribution. M : male, F : female, TBI : traumatic brain injury.

Fig. 6.

Severity of brain injury (A) and GCS score at admission (B) and discharge (C) according to sex. GCS : Glasgow coma scale.

Fig. 7.

Cause of death (A) and the time interval from traumatic brain injury to death (B) in non-survivors.