Table 1.
Studies Assessing Mortality or Function after Geriatric Mild TBI
| Study; design | Site | N | Age | Population | Time points | Functional Outcomes | Compared with young? | Predictors |
|---|---|---|---|---|---|---|---|---|
| Kristman and colleagues l, 2016171; Pro | Multi-center, Canada | 49 | ≥65 | Mild TBI discharged from ED | 6mo | 6mo GOSE 5–4: 80% <4: 20% |
N | Pre-TBI health status, depression, fatigue, and poor expectations for recovery predicted worse outcome |
| Cheng and colleagues, 2014234; Retro | Nation-wide health insurance claims database, Taiwan | 5997 | ≥65 | Mild TBI | Variable, up to 5y | Mortality 14.5% |
N | Although mortality percent higher in controls without mild TBI (N = 84,117; mortality 19.7%) adjusted survival models identified increased risk of death after mild TBI compared with controls without TBI. |
| McIntyre and colleagues et al, 201314; Retro | Meta-analysis 1989–2011 | 6 studies | ≥60 | Mild TBI (GCS 13–15) | Variable, up to 6mo | Mortality 12.3% |
N | — |
| McIntyre and colleagues, 2013154; Retro | Meta-analysis 1986–2008 | 5 studies | ≥60 | Mild TBI (GCS 13–15) | 12mo | GOS 5–4: 80.5% 3–2: 7.0% 1 (mortality): 10.7% |
N | — |
| Flaada and colleagues, 2007175; Retro | Population-based, Olmsted County, U.S. | 99 | ≥65 | Mild TBI | 6mo, 10y | Mortality 6mo: 9.1% 10y: 51.5% |
Y (N = 1173) | Mortality among survivors >6mo not greater than predicted for normal aging (survivors to 6 months should expect to have normal life span for age). Relative increases in TBI-related mortality with increasing age are not greater than expected compared with population-based mortality estimates. |
| LeBlanc and colleagues, 20066; Retro | Single-center, Canada | 476 | ≥60 | Mild TBI | Hospital discharge | In-hospital mortality 8.4% 44.8% discharged to home |
Y (N = 1003) | — |
| Mosenthal and colleagues, 200417; Pro | Multi-center, U.S. | 40 | ≥65 | Mild TBI (GCS 13–15) evaluated at a trauma center who survived to hospital discharge | Hospital discharge, 6mo | Hospital discharge Mean modified FIM 10.4 68% independent GOS 5: 63% GOS 4: 14% GOS 3: 23% 6mo Mean modified FIM 11.0 |
Y (N = 142) | — |
This table summarizes outcomes data for identified studies that report group-level mortality or functional outcomes after geriatric TBI. Whereas primary outcomes reported in each study may differ from those reported in this table, data displayed here were chosen to optimize direct comparison across studies.
ED, emergency department; FIM, functional independence measure; GCS, Glasgow Coma Scale; GOS, Glasgow Outcome Scale; GOSE, Glasgow Outcome Scale-Extended; Pro, prospective; Retro, retrospective; TBI, traumatic brain injury.