Table 2.
Studies Assessing Mortality or Function after Geriatric All-Severity TBI
| Study; design | Site | Geriatric TBI N | Age | Population | Time points | Functional Outcomes | Comparison to younger TBI? | Predictors |
|---|---|---|---|---|---|---|---|---|
| Peck and colleagues, 201437; Retro | Single-center, U.S. | 353 | ≥55 | TBI who survived initial hospitalization | 6mo, 12mo | Mortality 6mo 10.6% 12mo 13.4% |
N | Older age, pre-injury anticoagulant use, more comorbidities, discharge to long-term care facility, and severe disability (but not TBI severity) predicted post-discharge mortality |
| McIntyre and colleagues, 201314; Retro | Meta-analysis 1989–2011 | 22 studies | ≥60 | All-severity TBI | Variable, up to 10y | Mortality 38.3% |
N | — |
| Dijkers and colleagues, 2013216; Pro | Multi-center, U.S. | 339 | ≥65 | All-severity TBI admitted to inpatient rehabilitation | Inpatient rehab admission, discharge and 3 and 9mo post-discharge | Detailed motor and cognitive FIM scores at admission, discharge, 3mo, and 9mo by 10-year age categories Mortality 3mo: ∼5% 9mo: ∼13% ∼70% discharged to home |
Y (N = 1078) | — |
| Graham and colleagues, 2010205; Retro | Multi-center (Uniform Data System for Medical Rehabilitation), U.S. | 18,413 | ≥65 | TBI admitted to inpatient rehabilitation, living at home pre-injury | Inpatient rehab admission and discharge | FIM (mean) Admission: 56 ± 19 Discharge: 81 ± 23 66% discharged to home |
N | Older age predicted worse functional outcome |
| Bhullar and colleagues, 2010235; Retro | Single-center, U.S. | 328 | ≥65 | All-severity TBI evaluated at trauma center | Variable, up to 3y | Mortality Age 65–80y: 21% Age >80y: 6% |
Y (N = 2041) | Trend toward lower mortality in oldest old (>80y) compared to younger old |
| Yap and colleagues, 200838; Retro | Single-center, Singapore | 52 | ≥55 | All-severity TBI admitted to inpatient rehabilitation (31% severe by GCS <9; 90% severe by PTA >1 week) | Inpatient rehab admission, discharge, 6mo | GOS discharge 5: 0% 4: 3.8% 3: 92.3% 2: 1.9% 1 (mortality): 1.9% GOS 6mo 5: 3.8% 4: 17.3% 3: 63.5% 2: 1.9% 1 (mortality): 3.8% 90% discharged to home |
N | — |
| Chang and colleagues, 2008217; Retro | Nationally representative sample (Uniform Data System for Medical Rehabilitation), U.S. | 9240 | ≥65 | All-severity TBI admitted to inpatient rehabilitation | Inpatient rehab discharge | FIM (mean ± SD) White: 82 ± 25 Black: 75 ± 27 Hispanic: 80 ± 26 Discharged to home White: 62% Black: 65% Hispanic: 71% |
N | White race predicted better FIM at discharge but less likely to be discharged to home compared to black or Hispanic |
| Frankel and colleagues, 200620; Retro | TBI Model Systems Database, U.S. | 267 | ≥55 | All-severity TBI admitted to inpatient rehabilitation | Inpatient rehab admission and discharge | FIM (mean ± SD) Admission: 54 ± 23 Discharge: 88 ± 24 DRS (mean ± SD) Admission: 12 ± 5 Discharge: 7 ± 4 81% discharged to home |
Y (N = 267) | — |
| Susman and colleagues, 2002236; Retro | New York State Trauma Registry, U.S. | 3244 | ≥65 | All-severity TBI evaluated at a trauma center | Hospital discharge | Mortality 24% FIM %abnormal Expression: 17% Feeding: 34% Locomotion: 36% 54% discharged to extended care |
Y (N = 8528) | — |
| Rothweiler and colleagues, 199897; Pro | Single-center, U.S. | 25 | ≥60 | All-severity TBI admitted to trauma center who survived 1 month | 1y | GOSE 5: 20% Mortality: ∼30% Achieved pre-injury living situation: ∼45% |
Y (N = 386) | — |
| Cifu and colleague, 199618; Pro | Multi-center (TBI Model Systems), U.S. | 50 | ≥55 | All-severity TBI admitted to inpatient rehab (mean ± SD GCS 10 ± 4) | Inpatient rehab admission and discharge |
FIM (mean ± SD) Admission: 52 ± 25 Discharge: 91 ± 28 DRS (mean ± SD) Admission: 14 ± 5 Discharge: 7 ± 4 82% discharged to community setting |
Y (N = 50) | — |
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.
DRS, disability rating scale; IVH, intraventricular hemorrhage; ICU, intensive care unit; PTA, post-traumatic amnesia; SD, standard deviation; TBI, traumatic brain injury. Other abbreviations per Table 1.