Citation

Patel HC, Bouamra O, Woodford M, Yates DW, Lecky FE. Acta Neurochir. (Wien) 2010; 152(8): 1353-7; discussion 1357.

Affiliation

Department of Neurosurgery, Hope Hospital, Salford, M6 8HD, UK.

Copyright

(Copyright © 2010, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00701-010-0666-x

PMID

20437280

Abstract

BACKGROUND: Age is an important factor in determining prognosis following severe head injury (SHI), although mortality in patients >/=65 years is poorly reported. The aim of this study was to document mortality in patients with SHI >/=65 years. METHODS: A retrospective analysis of prospectively collected data from the TARN (Trauma Audit and Research Network) database (1996-2004) was performed. Six hundred and sixty-nine patients aged >/=65 with a GCS <9 after a head injury were identified, and mortality at 3 months was recorded. FINDINGS: Mortality was 71% in 65- to 70-year-old patients (n = 137) (CI, 64-79), 75% for patients aged 70-75 years (n = 147) (CI, 68-82), 85% in patients aged 75-80 years (n = 160) (79-91), and 87% for patients >80 years (n = 225) (CI, 83-91). Mortality for all patients >/=65 years with a GCS 3-5 was >80%. A better outcome was observed in patients with a GCS = 6-8 65-70 years, 47% (CI, 30-64); 70-75 years, 56% (CI, 43-69); 75-80 years, 73% (CI, 62-85); >80 years, 79% (CI, 70-87). CONCLUSIONS: SHI-related mortality continues to increase with age. Overall, these data support a conservative approach to the severely head-injured elderly patient; however, patients presenting with a GCS = 6-8 and below the age of 75 may represent a group where more aggressive therapy may be indicated.

Language: en