One-year outcome following brain injury: a comparison of younger versus elderly major trauma patients.

Abstract

The increasing number of older trauma patients has provoked a debate on the need for subsequent rehabilitative therapy for the elderly. Our findings revealed a lack of detailed data on this topic so we became interested in the effective differences in the longer-term outcomes for older and younger major trauma patients with TBI. As validation studies on the recently published specific Quality of Life after Brain Injury (QOLIBRI) have only involved patients under the age of 68years, we focused on testing this score in comparison to other outcome measures. Prospective cohort study of the differences in 1-year functional or health-related quality of life (HRQoL) outcomes, such as the Glasgow Outcome Score (GOS), the Quality of Life after Brain Injury (QOLIBRI) score or the medical outcomes study Short Form-36 (SF-36) between younger (16-64years) and elderly (> 65years) adults following major trauma (New Injury Severity Score, NISS ≥ 8) with TBI (Abbreviated Injury Scale, AIS head > 0). Out of 326 TBI patients with a mean NISS of 20.6 ± 9.4 34% (n = 110 (33.7%)) were aged 65 or older versus n = 216 (66.3%) who were younger. Comparison of 1-year outcomes revealed no differences between younger versus elderly patients with regard to functional or HRQoL scores (e.g. total QOLIBRI 77.4 ± 20.0 and 75.6 ± 18.1, resp.). Univariate analysis showed no correlation of the total QOLIBRI with age (Pearson r = - 0.09) or trauma severity (AIS) of the head (r = - 0.05). Multivariate analysis confirmed an association of age 80 or older (R2 = 0.026, p = 0.029), but not of overall age (R2 = 0.004, p = 0.218) with 1-year outcome scores on the total QOLIBRI. Given the rising rehabilitation demands of the elderly these pilot findings call for the utilisation of specific outcome scores such as the QOLIBRI in this age group as well, at least up to an age of 80years and independently of the severity of TBI sustained.