Traumatic brain injury in the elderly with high Glasgow coma scale and low injury severity scores: Factors influencing outcomes

Current trauma activation guidelines do not clearly address age as a risk factor when leveling trauma patients. Glasgow coma scale (GCS) and mode of injury play a major role in leveling trauma patients. We studied the above relationship in our elderly patients presenting with traumatic head injury....

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Bibliographic Details
Published in:The American journal of emergency medicine 2022-01, Vol.51, p.354-357
Main Authors: Bick, Heather, Wasfie, Tarik, Labond, Virginia, Hella, Jennifer R., Pearson, Eric, Barber, Kimberly R.
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants
Brain Concussion - epidemiology
Brain Concussion - etiology
Brain Injuries, Traumatic - classification
Brain Injuries, Traumatic - complications
Brain Injuries, Traumatic - mortality
Coma
Comorbidity
Concussion
Emergency medical care
Emergency medical services
Emergency Service, Hospital
Female
Glasgow Coma Scale
Head injuries
Humans
Injury Severity Score
Length of Stay - statistics & numerical data
Male
Middle Aged
Mortality
Patients
Proportional Hazards Models
Regression analysis
Retrospective Studies
Risk factors
Subarachnoid hemorrhage
Subarachnoid Hemorrhage - epidemiology
Subarachnoid Hemorrhage - etiology
Trauma Centers
Traumatic brain injury
Triage
Young Adult
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Summary:Current trauma activation guidelines do not clearly address age as a risk factor when leveling trauma patients. Glasgow coma scale (GCS) and mode of injury play a major role in leveling trauma patients. We studied the above relationship in our elderly patients presenting with traumatic head injury. This study was a retrospective analysis of patients who presented to the emergency department with traumatic brain injuries. We classified the 270 patients into two groups. Group A was 64 years and younger, and group B was 65 years and older. Their GCS, ISS, age, sex, comorbidities, and anticoagulant use were abstracted. The primary outcome was mortality and length of stay. The groups were compared using an independent student's t-test and Chi-square analysis. The Cox regression analysis was used to analyze differences in the outcome while adjusting for the above factors. There were 140 patients in group A, and 130 patients in group B who presented to the ED with a GCS of 14–15 and an ISS of below 15. The mean ISS significantly differed between group A (6.2 ± 6.8) vs (7.9 ± 3.2) in group B (p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2021.11.005