Introduction: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. Methods: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. Results: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. Conclusion: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.

(2022). Health care utilization and outcomes in older adults after Traumatic Brain Injury: a CENTER-TBI study. INJURY [10.1016/j.injury.2022.05.009].

Health care utilization and outcomes in older adults after Traumatic Brain Injury: a CENTER-TBI study

Citerio, Giuseppe;Vargiolu, Alessia;
2022

Abstract

Introduction: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. Methods: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. Results: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. Conclusion: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.
Articolo in rivista - Articolo scientifico
Scientifica
Health care utilization; Health-related quality of life; Mental health; Older adults; Outcomes; Traumatic Brain Injury;
English
(2022). Health care utilization and outcomes in older adults after Traumatic Brain Injury: a CENTER-TBI study. INJURY [10.1016/j.injury.2022.05.009].
van der Vlegel, M; Mikolić, A; Hee, Q; Kaplan, Z; Helmrich, I; van Veen, E; Andelic, N; Steinbuechel, N; Plass, A; Zeldovich, M; Wilson, L; Maas, A; Haagsma, J; Polinder, S; Åkerlund, C; George, P; Lanyon, L; Muraleedharan, V; Nelson, D; Amrein, K; Ezer, E; Kovács, N; Melegh, B; Nyirádi, J; Tamás, V; Vámos, Z; Sorinola, A; Andelic, N; Andreassen, L; Anke, A; Frisvold, S; Antoni, A; Schwendenwein, E; Audibert, G; Azouvi, P; Azzolini, M; Beretta, L; Calvi, M; Bartels, R; Boogert, H; Barzó, P; Beauvais, R; Perera, N; Beer, R; Helbok, R; Bellander, B; Belli, A; Benali, H; Degos, V; Galanaud, D; Perlbarg, V; Berardino, M; Cavallo, S; Blaabjerg, M; Rosenlund, C; Schou, R; Bragge, P; Brazinova, A; Majdan, M; Taylor, M; Zelinkova, V; Brinck, V; Jarrett, M; Brooker, J; Donoghue, E; Synnot, A; Brorsson, C; Koskinen, L; Sundström, N; Buki, A; Czeiter, E; Bullinger, M; Cabeleira, M; Czosnyka, M; Dixit, A; Ercole, A; Koraropoulos, E; Menon, D; Newcombe, V; Richter, S; Smielewski, P; Stamatakis, E; Williams, G; Winzeck, S; Zeiler, F; Caccioppola, A; Calappi, E; Carbonara, M; Ortolano, F; Zoerle, T; Stocchetti, N; Cameron, P; Gantner, D; Murray, L; Trapani, T; Vallance, S; Lozano, G; Pomposo, I; Castaño-León, A; Gomez, P; Lagares, A; Chevallard, G; Chieregato, A; Citerio, G; Vargiolu, A; Ceyisakar, I; Gravesteijn, B; Haagsma, J; Huijben, J; Lingsma, H; Nieboer, D; Mikolic, A; Polinder, S; Sewalt, C; Steyerberg, E; Velt, K; Voormolen, D; Wiegers, E; Peul, W; van Dijck, J; van Essen, T; van Wijk, R; Clusmann, H; Coburn, M; Kowark, A; Rossaint, R; Coles, J; Cooper, J; Correia, M; Čovid, A; von Steinbüchel, N; Curry, N; Stanworth, S; Dahyot-Fizelier, C; Dark, P; Johnson, F; Dawes, H; Esser, P; van Heugten, C; De Keyser, V; Maas, A; Menovsky, T; Van der Steen, G; Corte, F; Grossi, F; Depreitere, B; Đilvesi, Đ; Golubovic, J; Karan, M; Vulekovic, P; Dreier, J; Vajkoczy, P; Wolf, S; Dulière, G; Maréchal, H; Fabricius, M; Kondziella, D; Feigin, V; Jones, K; Ao, B; Theadom, A; Foks, K; Haitsma, I; Volovici, V; Furmanov, A; Rosenthal, G; Gagliardo, P; Gao, G; Jiang, J; Ghuysen, A; Giga, L; Valeinis, E; Ziverte, A; Glocker, B; Rueckert, D; Gratz, J; Gruen, R; Gupta, D; Roe, C; Helseth, E; Roise, O; Horton, L; Wilson, L; Hutchinson, P; Kolias, A; Jacobs, B; van der Naalt, J; Jankowski, S; Kompanje, E; Timmers, M; Laureys, S; Ledoux, D; Misset, B; Lecky, F; Olubukola, O; Lefering, R; Schäfer, N; Legrand, V; Lejeune, A; Vega, E; Mattern, J; Levi, L; Lightfoot, R; Maegele, M; Manara, A; Thomas, M; Manley, G; Martino, C; Sakowitz, O; Sanchez-Porras, R; Younsi, A; Mcmahon, C; Negru, A; Oresic, M; Palotie, A; Parizel, P; Payen, J; Persona, P; Piippo-Karjalainen, A; Pirinen, M; Ples, H; Posti, J; Puybasset, L; Radoi, A; Ragauskas, A; Raj, R; Rambadagalla, M; Rhodes, J; Richardson, S; Ripatti, S; Rocka, S; Rosand, J; Rosenfeld, J; Rossi, S; Rusnák, M; Sahuquillo, J; Sandor, J; Schmidt, S; Schoechl, H; Schoonman, G; Skandsen, T; Stevens, R; Stewart, W; Takala, R; Tamosuitis, T; Tenovuo, O; Tibboel, D; Tolias, C; Tudora, C; van der Jagt, M; Van Hecke, W; Van Praag, D; Vyvere, T; Verheyden, J; Vespa, P; Vik, A; Vilcinis, R; Wang, K; Yang, Z; Ylén, P
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0020138322003291-main.pdf

embargo fino al 08/05/2023

Tipologia di allegato: Author’s Accepted Manuscript, AAM (Post-print)
Dimensione 728.86 kB
Formato Adobe PDF
728.86 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/379606
Citazioni
  • Scopus 0
  • ???jsp.display-item.citation.isi??? ND
Social impact