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Geriatric TBI

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...
May 25, 2016: 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]
Kimberly A Peck, Richard Y Calvo, Mark S Schechter, C Beth Sise, Jessica E Kahl, Meghan C Shackford, Steven R Shackford, Michael J Sise, Donald J Blaskiewicz
BACKGROUND: Anticoagulants and prescription antiplatelet (ACAP) agents widely used by older adults have the potential to adversely affect traumatic brain injury (TBI) outcomes. We hypothesized that TBI patients on preinjury ACAP agents would have worse outcomes than non-ACAP patients. METHODS: This was a 5.5-year retrospective review of patients 55 years and older admitted to a Level I trauma center with blunt force TBI. Patients were categorized as ACAP (warfarin, clopidogrel, dipyridamole/aspirin, enoxaparin, subcutaneous heparin, or multiple agents) or non-ACAP...
February 2014: Journal of Trauma and Acute Care Surgery
Walter Mauritz, Alexandra Brazinova, Marek Majdan, Johannes Leitgeb
BACKGROUND: Traumatic brain injury (TBI) is an important cause of preventable deaths. The goal of this study was to provide data on epidemiology of TBI in Austria. METHODS: Data on all hospital discharges, outpatients, and extra- as well as in-hospital deaths due to TBI were collected from various sources for the years 2009-2011. Population data (number of male/female people per age-group, population of Austrian cities, towns, and villages) for 2009-2011 were collected from the national statistical office...
January 2014: Wiener Klinische Wochenschrift
Linda Ritchie, Valerie A Wright-St Clair, Justin Keogh, Marion Gray
OBJECTIVE: To explore the scope, reliability, and validity of community integration measures for older adults after traumatic brain injury (TBI). DATA SOURCES: A search of peer-reviewed articles in English from 1990 to April 2011 was conducted using the EBSCO Health and Scopus databases. Search terms included were community integration, traumatic brain injury or TBI, 65 plus or older adults, and assessment. STUDY SELECTION: Forty-three eligible articles were identified, with 11 selected for full review using a standardized critical review method...
January 2014: Archives of Physical Medicine and Rehabilitation
Xianwei Zeng, Shun Pan, Zhenbo Hu
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality in China. The elderly population has the higher rates of TBI-related hospitalization and death. Traffic accidents are the major cause for TBI in all age groups except in the group of 75 years and older, in which stumbles occurred in nearly half of those who suffered TBI. Older age is known to negatively influence outcome after TBI. To date, investigators have identified a panel of prognostic factors that include initial Glasgow Coma Scale score, comorbidities, cerebrospinal fluid leakage, associated extracranial lesions, and other factors such as cerebral perfusion pressure on recovery after injury...
2012: Current Translational Geriatrics and Experimental Gerontology Reports
Linda Papa, Matthew E Mendes, Carolina F Braga
Mild traumatic brain injury (TBI) is an unfortunately common occurrence in the elderly. With the growing population of older adults in the United States and globally, strategies that reduce the risk of becoming injured need to be developed, and diagnostic tools and treatments that may benefit this group need to be explored. Particular attention needs to be given to polypharmacy, drug interactions, the use of anticoagulants, safety issues in the living environment, elder abuse, and alcohol consumption. Low-mechanism falls should prompt health care providers to consider the possibility of head injury in elderly patients...
September 1, 2012: Current Translational Geriatrics and Experimental Gerontology Reports
Amanda McIntyre, Swati Mehta, JoAnne Aubut, Marcel Dijkers, Robert W Teasell
PRIMARY OBJECTIVE: To examine mortality rates among older adults (≥60 years) post-traumatic brain injury (TBI). RESEARCH DESIGN: Systematic review and meta-analysis. METHODS AND PROCEDURES: Using multiple databases, a literature search was conducted for articles on mortality after TBI published up to July 2011. Information on patient characteristics (age, Glasgow Coma Scale (GCS), injury aetiology, etc.), mortality rates, time to death and study design was extracted and pooled...
2013: Brain Injury: [BI]
Hilaire J Thompson, Sharada Weir, Frederick P Rivara, Jin Wang, Sean D Sullivan, David Salkever, Ellen J MacKenzie
Despite the growing number of older adults experiencing traumatic brain injury (TBI), little information exists regarding their utilization and cost of health care services. Identifying patterns in the type of care received and determining their costs is an important first step toward understanding the return on investment and potential areas for improvement. We performed a health care utilization and cost analysis using the National Study on the Costs and Outcomes of Trauma (NSCOT) dataset. Subjects were persons 55-84 years of age with TBI treated in 69 U...
July 1, 2012: Journal of Neurotrauma
B Depreitere, G Meyfroidt, G Roosen, J Ceuppens, F Guiza Grandas
INTRODUCTION: Traumatic brain injury (TBI) in the elderly is becoming an increasingly frequent phenomenon. Studies have mainly analyzed the influence of age as a continuous variable and have not specifically looked at geriatric patients as a group. The aim of this study is to map the magnitude and characteristics of geriatric TBI and to identify factors contributing to their poorer outcome. MATERIAL AND METHODS: Based on the ICD-9 register of the University Hospitals Leuven demographic and clinical variables of TBI were analyzed (2002-2008)...
2012: Acta Neurochirurgica. Supplement
Shoji Yokobori, Akihiro Watanabe, Gaku Matsumoto, Hidetaka Onda, Tomohiko Masuno, Akira Fuse, Shigeki Kushimoto, Hiroyuki Yokota
Age may be an independent predictor of outcomes in traumatic brain injury (TBI), but the causes of the poor outcomes in elderly patients remain unclear. To clarify the differences between elderly and young patients with TBI, brain metabolism parameters were monitored with the microdialysis method in 30 patients with severe TBI (Glasgow Coma Scale scores 3-8). The microdialysis probe was inserted in the penumbra area of the brain and extracellular levels of glucose, glutamate, glycerol, lactate, and pyruvate were measured hourly for the initial 168 hours (7 days) after operation...
2011: Neurologia Medico-chirurgica
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