Long-term outcome in elderly patients after operation for traumatic intracranial hemorrhage.
OBJECTIVE: This study examined outcomes in elderly TBI patients who underwent a cranial operation.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Published In/Presented At
Cipolle, M. D., Geffe, K., Getchell, J., Reed, J. F., 3rd, Fulda, G., Sugarman, M., & Tinkoff, G. H. (2014). Long-term outcome in elderly patients after operation for traumatic intracranial hemorrhage. Delaware medical journal, 86(8), 237–244.
Medicine and Health Sciences
Department of Surgery