Geriatric Traumatic Brain Injury in China

Zeng, Xianwei; Pan, Shun; Zhen-bo, Hu

doi:10.1007/s13670-012-0018-1

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…The prevalence of serious head injury and/or being knocked unconscious or reporting only a concussion ranged from 25.9% to 10.1% in BMHS participants aged 50+ years and this broadly concurs with other studies from China [ 23 ] and Australia [ 24 ] which reported prevalence rates of around 19% and 24.1% of TBI and concussion, respectively, but our rates are lower than the 45% reported in a UK cohort of older trauma patients [ 25 ].…”

Section: Discussionsupporting

confidence: 90%

Association between head injury and concussion with retinal vessel caliber

et al. 2018

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The adverse long-term consequences following traumatic brain injury are poorly understood, particularly on the cerebral microvasculature. Retinal vessels are a surrogate marker of cerebral vascular changes. We therefore aimed to examine the cross-sectional association between serious head injury or being knocked unconscious, and/or concussion and retinal microvascular signs, specifically, mean retinal arteriolar and venular calibre, in older adults after accounting for potential confounders. This cohort study involved 2,624 adults with mean age of 66.9 (±9.1) years who self-reported head injury and concussion parameters, and had gradable retinal photographs. Face-to-face interviews with trained interviewers allowed participants to report prior serious head injury or being knocked unconscious, and/or a previous diagnosis of concussion by a medical professional. Fundus photographs were taken and retinal vascular calibre measured using computer-assisted techniques and summarized. There were 25.9%, 15.3% and 10.1% who reported a prior serious head injury or being “knocked unconscious”, concussion, and both, respectively. Participants in the first group compared to non-injured participants had significantly wider (~2 μm) mean retinal venular calibre (p = 0.02), after adjusting for age, sex, smoking, body mass index, mean arterial blood pressure, type 2 diabetes and fellow vessel calibre. No significant associations were observed in people reporting medically diagnosed concussion or with mean retinal arteriolar calibre. Our exploratory study suggests that head injury is independently associated with wider retinal venular caliber. These findings warrant further investigation in longitudinal cohort studies.

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Section: Discussionsupporting

confidence: 90%

Association between head injury and concussion with retinal vessel caliber

et al. 2018

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“…In the literature, some studies report that male patients more frequently present with TBI in all age groups, whereas some other studies report that the frequency of female patients is higher. [17][18][19] According to our data, the most common reason for TBI in admitted patients was falling from the same level (76%). This is in accordance with previous reports, whereas one of the least common causes of TBI was motor vehicle collisions.…”

Section: Discussionmentioning

confidence: 61%

Travmatik Beyin Hasarı olan yaşlı hastalarda Prognostik Bilgisayarlı Tomografi Skorları karşılaştırması: Retrospektif bir çalışma

Bozan¹,

Altunok²

2022

Journal of Contemporary Medicine

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This study aimed to compare the Rotterdam and Helsinki computed tomography (CT) scoring systems for predicting the 30-day mortality after traumatic brain injury (TBI) in the geriatric population. Material and Method: Patients aged ≥65 years presenting to the emergency department with trauma-related complaints were retrospectively scanned using International Classification of Disease codes, and patients with isolated head trauma examined using brain CT were included. Demographic data including age, gender, trauma mechanisms, Glasgow Coma Scale (GCS) score at the time of admission, light reflex information, intubation, and surgery status, and emergency department outcomes were recorded. Brain CT images were investigated to calculate the Rotterdam and Helsinki CT scores and the relationship between them was examined. Results: Of the 890 included patients, 403 (45.3%) were male. Overall, 683 patients fell from a height of <1 m and 195 suffered injuries by hitting or direct impact. Further, the 30-day mortality rate was examined, revealing that 868 patients were alive and 22 patients died. Mortality rate was 3.7% for males and 1.4% for females. The Rotterdam and Helsinki CT scores and 30-day mortality was analyzed using receiver operating characteristic curve analysis, and the area under the curve was found as 0.564 and 0.603, respectively. The specificity of Rotterdam and Helsinki CT scoring systems in predicting 30-day mortality was 99.08% and 99.19%, respectively. Conclusion The use of CT scoring systems such as Rotterdam and Helsinki in the geriatric population presenting with TBI allows us to predict 30-day mortality.

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“…35 Results of our study mirror worldwide trends in developed countries where visits to the ED, inpatient hospitalizations, and mortalities from TBI are increasing in older adults, but are stable or decreasing in other age groups, even accounting for population shifts. These trends are demonstrated in numerous international studies from Australia, 36 Austria, 37 Canada, [38][39][40] China, 41,42 Finland, [43][44][45] Germany, 46 Great Britain, 47 Japan, 48 the Netherlands, 49 Scotland, 50 Spain, 43,51 and the United States. 52 Trends in less developed countries are harder to assess.…”

Section: Discussionmentioning

confidence: 93%

The burden of geriatric traumatic brain injury on trauma systems: Analysis of 348,800 Medicare inpatient claims

Fakhry

Shen

Garland

et al. 2022

J American Geriatrics Society

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Background Traumatic brain injury (TBI) is a leading cause of death and disability in older adults. The aim of this study was to characterize the burden of TBI in older adults by describing demographics, care location, diagnoses, outcomes, and payments in this high‐risk group. Methods Using 2016–2019 Centers for Medicare & Medicaid Services (CMS) Inpatient Standard Analytical Files (IPSAF), patients >65 years with TBI (>1 injury ICD‐10 starting with “S06”) were selected. Trauma center levels were linked to the IPSAF file via American Hospital Association Hospital Provider ID and fuzzy‐string matching. Patient variables were compared across trauma center levels. Results Three hundred forty‐eight thousand eight hundred inpatients (50.4% female; 87.1% white) from 2963 US hospitals were included. Level I/II trauma centers treated 66.9% of patients; non‐trauma centers treated 21.5%. Overall inter‐facility transfer rate was 19.2%; in Level I/II trauma centers transfers‐in represented 23.3% of admissions. Significant TBI (Head AIS ≥3) was present in 70.0%. Most frequent diagnoses were subdural hemorrhage (56.6%) and subarachnoid hemorrhage (30.6%). Neurosurgical operations were performed in 10.9% of patients and operative rates were similar regardless of center level. Total unadjusted mortality for the sample was 13.9%, with a mortality of 8.1% for those who expired in‐hospital, and an additional 5.8% for those discharged to hospice. Medicare payments totaled $4.91B, with the majority (73.4%) going to Level I/II trauma centers. Conclusions This study fills a gap in TBI research by demonstrating that although the majority of older adult TBI patients in the United States receive care at Level I/II trauma centers, a substantial percentage are managed at other facilities, despite 1 in 10 requiring neurosurgical operation regardless of level of trauma center. This analysis provides preliminary data on the function of regionalized trauma care for older adult TBI care. Future studies assessing the efficacy of early care guidelines in this population are warranted.

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Geriatric Traumatic Brain Injury in China

Cited by 11 publications

References 30 publications

Association between head injury and concussion with retinal vessel caliber

Association between head injury and concussion with retinal vessel caliber

Travmatik Beyin Hasarı olan yaşlı hastalarda Prognostik Bilgisayarlı Tomografi Skorları karşılaştırması: Retrospektif bir çalışma

The burden of geriatric traumatic brain injury on trauma systems: Analysis of 348,800 Medicare inpatient claims

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