Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study
Van Der Vlegel M, Mikolic A, Hee QL, Kaplan ZLR, Helmrich IRAR, Van Veen E, Andelic N, Steinbuechel NV, Plass AM, Zeldovich M, Wilson L, Maas AIR, Haagsma JA, Polinder S (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 53
Pages Range: 2774-2782
Journal Issue: 8
DOI: 10.1016/j.injury.2022.05.009
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.
Involved external institutions
Erasmus University Medical Center (MC)
Netherlands (NL)
Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet
Norway (NO)
Universitätsklinikum Göttingen
Germany (DE)
University of Stirling
United Kingdom (GB)
Antwerp University Hospital
Belgium (BE)
Netherlands (NL)
Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet
Norway (NO)
Universitätsklinikum Göttingen
Germany (DE)
University of Stirling
United Kingdom (GB)
Antwerp University Hospital
Belgium (BE)
How to cite
APA:
Van Der Vlegel, M., Mikolic, A., Hee, Q.L., Kaplan, Z.L.R., Helmrich, I.R.A.R., Van Veen, E.,... Polinder, S. (2022). Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study. Injury-International Journal of the Care of the Injured, 53(8), 2774-2782. https://doi.org/10.1016/j.injury.2022.05.009
MLA:
Van Der Vlegel, Marjolein, et al. "Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study." Injury-International Journal of the Care of the Injured 53.8 (2022): 2774-2782.
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