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Geriatric TBI

Nicole Osier, Emily McGreevy, Lan Pham, Ava Puccio, Dianxu Ren, Yvette P Conley, Sheila Alexander, C Edward Dixon
Melatonin (MEL) is a hormone that is produced in the brain and is known to bind to MEL-specific receptors on neuronal membranes in several brain regions. MEL's documented neuroprotective properties, low toxicity, and ability to cross the blood-brain-barrier have led to its evaluation for patients with traumatic brain injury (TBI), a condition for which there are currently no Food and Drug Administration (FDA)-approved therapies. The purpose of this manuscript is to summarize the evidence surrounding the use of melatonin after TBI, as well as identify existing gaps and future directions...
May 22, 2018: International Journal of Molecular Sciences
I J Gilete-Tejero, H Z Ippolito-Bastidas, L M Bernal-Garcia, J Mata-Gomez, R Garcia-Moreno, M Ortega-Martinez, J M Cabezudo-Artero
INTRODUCTION: In our setting, the ageing of the population has led to management of traumatic brain injury (TBI) in the later stages of life becoming an increasingly frequent problem. AIM: To evaluate the association between age and the functional and survival prognosis of patients who have undergone surgery due to TBI. PATIENTS AND METHODS: We performed a retrospective analysis of a series of 404 patients submitted to surgery between the years 2000 and 2015: 144 youngsters (12-44 years), 77 adults (45-64 years), 148 geriatric patients (65-79 years) and 26 'super geriatric' patients (> 80 years)...
February 16, 2018: Revista de Neurologia
Raquel C Gardner, Kristen Dams-O'Connor, Molly Rose Morrissey, Geoffrey T Manley
This review of the literature on traumatic brain injury (TBI) in older adults focuses on incident TBI sustained in older adulthood ("geriatric TBI") rather than on the separate, but related, topic of older adults with a history of earlier-life TBI. We describe the epidemiology of geriatric TBI, the impact of comorbidities and pre-injury function on TBI risk and outcomes, diagnostic testing, management issues, outcomes, and critical directions for future research. The highest incidence of TBI-related emergency department visits, hospitalizations, and deaths occur in older adults...
February 15, 2018: Journal of Neurotrauma
Hans Andrews, Katelyn Rittenhouse, Brian Gross, Frederick B Rogers
The incidence of geriatric traumatic brain injury (TBI) is increasing throughout the United States, with many of these patients taking anticoagulation (AC) medication. The purpose of this investigation was to determine the effect of time to international normalized ratio (INR) reversal on intracranial hemorrhage evolution in TBI patients taking prehospital AC medication. We hypothesized that rapid reversal of INR improves outcomes of head-injured patients taking AC medication. Admissions to a Level II trauma center between February 2011 and December 2013 were reviewed...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Muhammad Khan, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Abdullah Kattaa, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients. METHODS: We performed a 1-y (2011) retrospective analysis of isolated geriatric TBI patients (age ≥65 y, head abbreviated injury score [AIS] ≥ 3, and other body AIS < 3) in the National Trauma Data Bank...
August 2017: Journal of Surgical Research
Je Kyung Kim, Na Young Kim, Yong Wook Kim
OBJECTIVE: To identify predictors for depressive mood in geriatric patients after traumatic brain injury (TBI). METHODS: A retrospective review of patients' medical charts was performed in TBI patients who were older than 60 years and referred to the Department of Rehabilitation Medicine at Severance Hospital in 2002-2016. The patients were classified into two groups based on the Geriatric Depression Scale (GDS): non-depressive group (0≤GDS≤16) and depressive group (17≤GDS≤30)...
April 2017: Annals of Rehabilitation Medicine
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
2017: Brain Injury: [BI]
Xueyan Wan, Kai Zhao, Sheng Wang, Huaqiu Zhang, Liang Zeng, Yu Wang, Lin Han, Rajluxmee Beejadhursing, Kai Shu, Ting Lei
BACKGROUND: Many investigators endeavor to predict the outcome based on admission characteristics using some established models to determine which management should be applied. However, the efficacy and applicability of the models using in the geriatric patients with severe traumatic brain injury (TBI) have not yet been evaluated. METHODS: A total of 137 geriatric severe TBI patients were enrolled in this retrospective study. Receiver operating characteristic (ROC) curves were constructed to evaluate the efficacy and usability of the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) prognostic model in evaluating the prognosis for these patients...
July 2017: World Neurosurgery
Chiara S Haller, Cecile Delhumeau, Michael De Pretto, Rahel Schumacher, Laura Pielmaier, Marie My Lien Rebetez, Guy Haller, Bernhard Walder
OBJECTIVE: The objective was to investigate disability and health-related quality-of-life (HRQoL) 3, 6 and 12 months after traumatic brain injury (TBI) in non-geriatric (≤ 65 years) and geriatric patients (> 65 years). METHODS: Patients ≥ 16 years who sustained a severe TBI (Abbreviated Injury Scale of the head region > 3) were included in this prospective, multi-centre study. Outcome measures were Glasgow Outcome Scale Extended (GOSE; disability), SF-12 (HRQoL)...
2017: Brain Injury: [BI]
Tomoya Okazaki, Toru Hifumi, Kenya Kawakita, Ryuta Nakashima, Atsushi Matsumoto, Hajime Shishido, Daiske Ogawa, Masanobu Okauchi, Atsushi Shindo, Masahiko Kawanishi, Takashi Tamiya, Yasuhiro Kuroda
BACKGROUND: Several studies using trauma data banks and registers showed that age, Glasgow Coma Scale (GCS), Injury Severity Score, and intraventricular hemorrhage were independent factors for neurologic outcomes in geriatric patients with traumatic brain injury (TBI). However, these analyses did not comprehensively evaluate factors particularly associated with geriatric patients. We aimed to identify factors particularly associated with geriatric patients that affect neurologic outcomes in TBI...
September 2016: World Neurosurgery
Shoji Yokobori, Ryuta Nakae, Hiroyuki Yokota, Markus S Spurlock, Stefania Mondello, Shyam Gajavelli, Ross M Bullock
The prognosis for patients with traumatic brain injury (TBI) with subdural hematoma (SDH) remains poor. In accordance with an increasing elderly population, the incidence of geriatric TBI with SDH is rising. An important contributor to the neurological injury associated with SDH is the ischemic damage which is caused by raised intracranial pressure (ICP) producing impaired cerebral perfusion. To control intracranial hypertension, the current management consists of hematoma evacuation with or without decompressive craniotomy...
March 15, 2018: Behavioural Brain Research
Elizabeth J Lilley, Katherine J Williams, Eric B Schneider, Khaled Hammouda, Ali Salim, Adil H Haider, Zara Cooper
BACKGROUND: The Eastern Association for the Surgery of Trauma (EAST) recommends that clinicians consider limiting further aggressive treatment in geriatric patients with severe traumatic brain injury (TBI) who do not improve in 72 hours (nonresponders) owing to their poor prognosis. However, little is known about how these guidelines are followed in practice. This study compared mortality and patient care among geriatric patients with severe TBI classified as "responders" and "nonresponders" 72 hours after injury...
June 2016: Journal of Trauma and Acute Care Surgery
Carlos Eduardo Romeu de Almeida, José Lopes de Sousa Filho, Jules Carlos Dourado, Pollyana Anício Magalhães Gontijo, Marcos Antônio Dellaretti, Bruno Silva Costa
BACKGROUND: Traumatic brain injury (TBI) stands out as a grave social and economic problem. Emerging countries possess few epidemiologic studies on the range and impact of TBI. OBJECTIVE: Our study aimed to characterize the demographic, social, and economic profile of people suffering from TBI in Brazil. METHODS: Data on TBI cases in Brazil between 2008 and 2012 were collected through the website of the Information Technology Department of the Unified Health System (DATASUS) maintained by the Brazilian Ministry of Health...
March 2016: World Neurosurgery
Osvaldo P Almeida, Graeme J Hankey, Bu B Yeap, Jonathan Golledge, Leon Flicker
BACKGROUND: The incidence of traumatic brain injury (TBI) is rising, as are its neuropsychiatric complications. This study aims to determine (1) the prevalence of TBI, (2) the association between history of past TBI and sociodemographic, lifestyle and clinical factors, and (3) the risk of depression and cognitive impairment in later life associated with exposure to TBI. METHODS: Cross-sectional study of a community-derived sample of 5486 Australian men aged 70-89 years...
December 2015: International Journal of Geriatric Psychiatry
D Pöppl, R Deck, N Gerdes, U-N Funke, W Kringler, N Friedrich, T Kohlmann, P Reuther
OBJECTIVE: The scales Barthel-Index (BI) and Functional Independence Measure (FIM) are the most frequently used instruments for measurement of outcome in neurological rehabilitation. Both instruments show appropriate psychometric characteristics but there are some limitations for their use in outpatient neurorehabilitation. The "Score of Independence for Neurologic and Geriatric Rehabilitation (SINGER)" was developed to compensate the weaknesses of the established instruments and to facilitate a direct connection to the ICF...
February 2015: Die Rehabilitation
Bina R Patel
Today, as a result of the longest volunteer-fought conflict in U.S. history, there are many wounded coming home not only with posttraumatic stress disorder (PTSD), but also with traumatic brain injury (TBI), which together have been called the "signature" or "invisible" injuries of the Iraq and Afghanistan wars. Caregivers are an important part of their recovery, yet little is known about them, as previous research on caregivers mostly focused on geriatric populations. According to one estimate 275,000 to 1 million people are currently caring or have cared for loved ones who have returned from Iraq and Afghanistan...
January 2015: Social Work
Erin B Wasserman, Manish N Shah, Courtney M C Jones, Jeremy T Cushman, Jeffrey M Caterino, Jeffrey J Bazarian, Suzanne M Gillespie, Julius D Cheng, Ann Dozier
OBJECTIVE: We sought to identify a scale or components of a scale that optimize detection of older adult traumatic brain injury (TBI) patients who require transport to a trauma center, regardless of mechanism. METHODS: We assembled a consensus panel consisting of nine experts in geriatric emergency medicine, prehospital medicine, trauma surgery, geriatric medicine, and TBI, as well as prehospital providers, to evaluate the existing scales used to identify TBI. We reviewed the relevant literature and solicited group feedback to create a list of candidate scales and criteria for evaluation...
April 2015: Prehospital Emergency Care
A Kehoe, S Rennie, J E Smith
OBJECTIVES AND BACKGROUND: Elderly patients comprise an ever-increasing proportion of major trauma patients. The presenting GCS in elderly patients with traumatic brain injury (TBI) may not reflect the severity of injury as accurately as it does in the younger patient population. However, GCS is often used as part of the decision tool to define the population transferred directly to a major trauma centre. The aim of this study was to explore the relationship between age and presenting GCS in patients with isolated TBI...
August 2015: Emergency Medicine Journal: EMJ
Kentaro Shimoda, Takeshi Maeda, Masahiro Tado, Atsuo Yoshino, Yoichi Katayama, M Ross Bullock
OBJECTIVE: As the aged population is rapidly growing globally, geriatric traumatic brain injury (TBI) becomes an increasing problem. There are higher mortality and poorer functional outcome in the geriatric TBI population (≥65 years) compared with younger groups despite neurosurgical interventions. Therefore, current treatment priorities and cost-effectiveness should be critically examined. We evaluated the benefit of surgical management in the elderly (≥65 years) after TBI. METHODS: A total of 3194 patients with confirmed TBI were enrolled from 1998 to 2011, in the Japan Neurotrauma Data Bank...
December 2014: World Neurosurgery
Walter Mauritz, Alexandra Brazinova, Marek Majdan, Veronika Rehorcikova, Johannes Leitgeb
BACKGROUND: To investigate changes in TBI mortality in Austria during 1980-2012 and to identify causes for these changes. METHODS: Statistik Austria provided data (from death certificates) on all TBI deaths from January 1980-December 2012. Data included year/month of death, age, sex, residency of the cases and mechanism of accident. Data regarding the size of the age groups was obtained from Statistik Austria. Mortality rates (MR; deaths/10(5) population/year) were calculated for male vs...
2014: Brain Injury: [BI]
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