One-year results in elderly patients with severe head injury

Abstract

Background: This study explored the outcome of older adults with severe head injury after 1-year follow-up. Materials and Methods: Data were collected from the hospital medical information system. The patients who suffered from severe head injury met with the disease classification system, traumatic statistics, with or without brain surgery, and patient medical records of a regional teaching hospital were included in the study. Patients were followed with telephone contact 1 year after discharge. The Glasgow Outcome Scale and the Functional Independence Measure were used as tools for prognostic evaluation. This study protocol was approved by the institutional review board of the hospital. Results: Patients who were 65 years of age and older diagnosed with severe head injury (Injury Severity Score 2 ≥16) were included. Between January 2009 and September 2015, a total of 142 patients were collected with 88 men (62%) and 54 women (38%). The mean age was 76.6 ± 6.6 years. Head injury was caused by traffic accidents for 73 patients (51.4%) and by falls for 69 patients (48.6%). There were 122 patients with subdural hemorrhage, 82 with intracerebral hemorrhage, 71 with subarachnoid hemorrhage, and 11 with epidural hemorrhage. Forty-one patients (28.9%) had simple head injury and 101 patients had multiple head injuries. The mean Glasgow Coma Scale was 5.4 ± 1.9, and the mean ISS was 24.3 ± 9.2. Thirty-eight patients (26.8%) refused surgery and 104 patients (73.2%) underwent brain surgery. Among 142 patients, 70 (49.3%) died and 72 (50.7%) survived, with 16 patients (11.3%) classified as good condition and 126 (88.7%) as poor condition. After 1 year, those who underwent brain surgery had a better prognosis than those who refused surgery (P = 0.01). Conclusion: Older adults with severe head injuries often face disability, a vegetative state, or death. In this study, those who underwent brain surgery had better survival, and 27.6% (16/58) of those who survived were able to live independently after 1 year.