Abstract
BackgroundIt is known that the risk of death in elderly patients with moderate to severe traumatic brain injury is increased. However, the relationship between mild traumatic brain injury and death has never been established. We investigated the mortality rates of older patients with mild traumatic brain injury in Taiwan to evaluate if there is a higher risk of death compared with the general population.MethodsWe utilized a sampled National Health Insurance claims database containing one million beneficiaries. We followed all adult beneficiaries older than 65 years from January 1, 2005 till December 31, 2009 to see if they died. We further identified patients with mild traumatic brain injury and compared their risk of death with the general population.ResultsWe identified 5997 patients with mild traumatic brain injury and 84,117 patients without mild traumatic brain injury. After controlling for age, gender, urbanization level, socioeconomic status, diabetes, hypertension, history of alcohol intoxication, history of ischemic stroke, history of intracranial hemorrhage, malignancies, dementia and Charlson Comorbidity Index score, the adjusted hazard ratio was 1.25 (95% confidence interval, 1.16—1.34).ConclusionsMild traumatic brain injury is an independent significant risk factor for death in the elderly.
Highlights
Each year, traumatic brain injury (TBI) accounts for 2.4 million emergency department visits, hospitalizations, or deaths in the United States, and the direct medical costs of TBI in 2010 were estimated to be $11.5 billion [1]
In a population-based controlled study, the hazard ratio (HR) of death was statistically significant in patients with moderate to severe TBI but not in patients with mild TBI
Our study aimed to investigate the correlation between mild TBI and death in the elderly by utilizing a large administration database to overcome the obstacles noted above
Summary
Patients older than 65 years with severe TBI had a 72% greater chance of death compared with younger patients [2]. Age at the time of injury was found to be associated with a higher risk of death after TBI, which shows that older patients are more vulnerable to TBI [3,4,5]. In a population-based controlled study, the hazard ratio (HR) of death was statistically significant in patients with moderate to severe TBI but not in patients with mild TBI. It is known that the risk of death in elderly patients with moderate to severe traumatic brain injury is increased. We investigated the mortality rates of older patients with mild traumatic brain injury in Taiwan to evaluate if there is a higher risk of death compared with the general population
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