Prediction of Neurological Outcomes in Elderly Patients With Head Trauma Using the Geriatric Trauma Outcome Score: A Retrospective Observational Study

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 8; p. e66768
• Main Authors: Iizawa, Yuta, Hayashi, Yosuke, Saito, Daiki, Kondo, Kengo, Yamashiro, Mana, Kanematsu, Rie, Hirose, Kimihito, Nakamura, Michio, Miyazaki, Tadashi
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 13.08.2024; Cureus
• Subjects: Activities of daily living; Aging; Anticoagulants; Brain research; Coma; Concussion; Contusions; Disability; Emergency medical care; Emergency Medicine; Epidural; Geriatrics; Head injuries; Hematoma; Hemorrhage; Hospitals; Length of stay; Mortality; Neurosurgery; Observational studies; Older people; Patients; Review boards; Trauma; Japan; outcome prediction; neurological outcome; elderly patients; cerebral performance category; head trauma; geriatric trauma outcome score
• DOI: 10.7759/cureus.66768
• ISSN: 2168-8184

Introduction Head trauma in elderly people is a problem in today's aging society. Elderly people are susceptible to head trauma because of their declining physical function; this tends to be severe. Outcome prediction is important in decision-making regarding treatment strategies; however, there is no unified method for predicting neurological outcomes in elderly patients with head trauma. Methods Elderly patients with head trauma admitted to the Japan Red Cross Narita Hospital between January 2019 and August 2023 were enrolled in this single-center, retrospective observational study. A favorable neurological outcome was defined as a cerebral performance category scale of 1 or 2. Multivariate logistic regression analysis and receiver operating characteristic curve analysis were performed to investigate the association between geriatric trauma outcome scores and outcomes and to evaluate the predictive value of geriatric trauma outcome scores. The primary outcome was a favorable neurological outcome at discharge, and the secondary outcome was in-hospital mortality. Results A total of 313 elderly patients with head trauma were eligible for analysis. Multivariate logistic regression analysis revealed that the geriatric trauma outcome score was significantly associated with a favorable neurological outcome at discharge (odds ratio 0.94, <0.0001). In the receiver operating characteristic curve analysis, the geriatric trauma outcome score had a good predictive value for favorable neurological outcomes at discharge (area under the receiver operating characteristic curve 0.83). Conclusions The geriatric trauma outcome score had good predictive value for favorable neurological outcomes at discharge in elderly patients with head trauma and has the potential to aid in decision-making regarding treatment strategies for elderly patients with head trauma.