Long-term outcome in elderly patients after operation for traumatic intracranial hemorrhage

• Published in: Delaware medical journal Vol. 86; no. 8; p. 237
• Main Authors: Cipolle, Mark D, Geffe, Kevin, Getchell, John, Reed, 3rd, James F, Fulda, Gerard, Sugarman, Michael, Tinkoff, Glen H
• Format: Journal Article
• Language: English
• Published: United States 01.08.2014
• Subjects: Age Factors; Aged; Aged, 80 and over; Cohort Studies; Craniotomy; Female; Glasgow Outcome Scale; Hospital Mortality; Humans; Intracranial Hemorrhage, Traumatic - mortality; Intracranial Hemorrhage, Traumatic - pathology; Intracranial Hemorrhage, Traumatic - surgery; Male; Survival Rate; Treatment Outcome
• ISSN: 0011-7781

This study examined outcomes in elderly TBI patients who underwent a cranial operation. We identified TBI patients > or = 65 who underwent a cranial operation from January 1, 2004 to December 31, 2008. Data collected included: age, admission GCS, mechanism of injury, ISS, Head AIS, type of operation, hemorrhage acuity, time to operation, pre-hospital warfarin or clopidogrel, and in-hospital death. Survivors were contacted by phone to determine an Extended Glasgow Outcome Score (GOSE). A favorable outcome was defined as having a GOSE of > or = 5 at follow-up, an unfavorable outcome was defined as: in-hospital death, death within one year of injury, and a GOSE < 5 at follow-up. Chi-square and student's t-test were used. One hundred sixty-four elderly TBI patients underwent cranial surgery. Mean age was 79.2 +/- 7.6 years. Most patients: had a ground level fall (86.0%), suffered a subdural hematoma (95.1%), and underwent craniotomy (89.0%). Twenty-eight percent died in the hospital and another 20.1% died within one year. Fifty-six patients were eligible for a GOSE interview of these: 17 were lost to follow-up, seven refused the GOSE interview, 22 had a GOSE > or = 5, and ten had a GOSE < 5. Mean follow-up was 42.6 +/- 14.9 months. Of all the factors analyzed, only older age was associated with an unfavorable outcome. While age was associated with outcome, we were unable to demonstrate any other early factors that were associated with long-term functional outcome in elderly patients that underwent a cranial operation for TBI.