Injury patterns, severity and outcomes among older adults who sustained brain injury following a same level fall: A retrospective analysis

Scheetz, Linda Jean

doi:10.1016/j.ienj.2014.09.003

Cited by 23 publications

(38 citation statements)

References 23 publications

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“…1,19,33 Even so, falls were more common in women than in men and accounted for a larger percentage of injuries among individuals with isolated TBI compared to all TBI cases. Older women were more likely than men to fall on the same level or on stairs.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in mortality following isolated traumatic brain injury among older adults

Albrecht

McCunn

Stein

et al. 2016

Journal of Trauma and Acute Care Surgery

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Background Older adults have the highest rates of hospitalization and mortality from traumatic brain injury (TBI), yet outcomes in this population are not well studied. In particular, contradictory reports on the protective effect of female sex on mortality following TBI may have been related to age differences in TBI and other injury severity and mechanism. The objective of this study was to determine if there are sex differences in mortality following isolated TBI among older adults and compare to findings using all TBI. A secondary objective was to characterize TBI severity and mechanism by sex in this population. Methods This was a retrospective cohort study conducted among adults aged 65 and older treated for TBI at a single large level I trauma center 1996–2012 (n=4,854). Individuals treated for TBI were identified using International Classification of Disease (ICD-9-CM) codes. Isolated TBI was defined as an Abbreviated Injury Scale score = 0 for other body regions. Our primary outcome was mortality at discharge. Results Among those with isolated TBI (n=1,320), women (45% of sample) were older (78.9 (standard deviation 7.7) years) than men (76.8 (7.5) years)(p<0.001). Women were more likely to have been injured in a fall (91% vs. 84%, p<0.001). Adjusting for multiple injury severity measures, female sex was not significantly associated with decreased odds of mortality following isolated TBI (OR 1.01; 95% CI 0.66, 1.54). Using all TBI cases, adjusted analysis found that female sex was significantly associated with decreased odd of mortality (OR 0.73; 95% CI 0.59, 0.89). Conclusions We found no sex differences in mortality following isolated TBI among older adults, in contrast with other studies and our own analyses using all TBI cases. Researchers should consider isolated TBI in outcome studies to prevent residual confounding by severity of other injuries. Level of Evidence Epidemiologic study, level III.

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Section: Discussionmentioning

confidence: 99%

Sex differences in mortality following isolated traumatic brain injury among older adults

Albrecht

McCunn

Stein

et al. 2016

Journal of Trauma and Acute Care Surgery

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“…The importance of chronic disease in mortality rate after trauma have been previously documented (13). In a secondary analysis of discharge data of TBI patients, Scheetz found that certain chronic conditions, including congestive heart failure, coagulation disorder, hypertension and malignancies, increased the odds of short-term mortality (14). A study by Liao and colleagues on 1104 TBI patients with end-stage renal disease (ESRD) and 3312 TBI patients without ESRD showed an increased risk of mortality among TBI patients with a pre-existing end-stage renal disease (15).…”

Section: Discussionmentioning

confidence: 99%

Adaptation of Traumatic Brain Injury Guidelines in Iran

et al. 2016

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ContextThe National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country.Evidence AcquisitionThe guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed.ResultsThe following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge.ConclusionsThe evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.

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“…The vast majority were ground level falls. Previous research has reported a 2.3% rate of ICH in low‐risk head injury patients (Glasgow Coma Scale of 15, no neurologic findings, no visible wounds, and no coagulation diseases or medications) and 11% in hospitalized head trauma patients …”

mentioning

confidence: 97%

“…This type of injury involves relatively low energy, especially compared to other mechanisms, such as motor vehicle accidents. Consequently, these events often are overlooked as opposed to being a red flag for potential TBI and ICH, or an opportunity to assess fall risk and prevention of future recurrences …”

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confidence: 99%

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Intracranial Hemorrhage in Older Adults: Implications for Fall Risk Assessment and Prevention

Shih

Ouslander

2020

J American Geriatrics Society

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Injury patterns, severity and outcomes among older adults who sustained brain injury following a same level fall: A retrospective analysis

Cited by 23 publications

References 23 publications

Sex differences in mortality following isolated traumatic brain injury among older adults

Sex differences in mortality following isolated traumatic brain injury among older adults

Adaptation of Traumatic Brain Injury Guidelines in Iran

Intracranial Hemorrhage in Older Adults: Implications for Fall Risk Assessment and Prevention

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