Journal
JOURNAL OF NEUROTRAUMA
Volume 30, Issue 16, Pages 1385-1390Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2013.2881
Keywords
contusion; elderly; head injury; trauma
Funding
- National Institute for Health Research [ACF-2011-21-011] Funding Source: researchfish
Ask authors/readers for more resources
Age has been identified as an independent risk factor for poor outcome following head injury in the elderly, and postulated reasons for this include nature, nurture, and variations in management. Do elderly head injuries do worse because of a self-fulfilling prophecy of poorer management? The aim of this study was to review the management of patients with cerebral contusions according to age to identify any trends. We retrospectively reviewed prospectively collected national data on cerebral contusion admissions between March 14, 1988, and May 4, 2012, to UK hospitals held in the Trauma Audit and Research Network database. Patients were included in the study if they had cerebral contusion(s) with an abbreviated injury score (AIS) of 3 or more; no other head injury with a AIS score of 4 or more, or no injury in any other body region with AIS score of 3 or more, and known outcome data. In total, 4387 patients met the inclusion criteria. Mortality was found to increase with increasing age (p < 0.001). However, time from admission to CT head imaging (p = 0.003) and the likelihood of not being transferred to a center with acute neurosurgical care facilities (p < 0.001) increased with increasing age, too. Further, there was a significant trend for the most senior grade of doctor to review more younger patients and for only the most junior grade of doctor to review more older patients (both, p < 0.001). To conclude, our data suggest differences in management practice may contribute to the observed differences in mortality between younger and older patients suffering brain contusions.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available