Risk factors for intracranial lesions and mortality in older patients with mild traumatic brain injuries

Primary Objective: To identify risk factors for intracerebral lesion (ICL) in older adults with mild traumatic brain injury (MTBI) and evaluate the influence of comorbidities on outcomes. Research Design: Prospective cohort study. Methods and Procedures: Information was gathered on clinical history/...

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Bibliographic Details
Published in:	Brain injury Vol. 32; no. 1; pp. 99 - 104
Main Authors:	Ibañez Pérez De La Blanca, Ma. Angustias, Fernández Mondéjar, Enrique, Gómez Jimènez, Francisco Javier, Alonso Morales, Jóse María, Lombardo, Ma. Dolores Quijano, Viso Rodriguez, Juan Luis
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 02-01-2018
Subjects:	Age Factors Aged Aged, 80 and over Brain - pathology Brain Concussion - mortality Brain Concussion - pathology Female Glasgow Coma Scale Humans Male Middle Aged neuroprotectors over 60 years Prospective Studies Risk Factors Score- Traumatic brain injury Survival Rate over 60 years Score- Traumatic brain injury neuroprotectors
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Summary:	Primary Objective: To identify risk factors for intracerebral lesion (ICL) in older adults with mild traumatic brain injury (MTBI) and evaluate the influence of comorbidities on outcomes. Research Design: Prospective cohort study. Methods and Procedures: Information was gathered on clinical history/examination, cranial computed tomography, admission Glasgow Coma Scale (GCS) score, analytical and coagulation findings, and mortality at 1 week post-discharge. Bivariate and multivariate logistic regression analyses were performed, calculating odds ratios for ICL with 95% confidence interval. P < 0.05 was considered significant. Main Outcomes and Results: Data were analyzed on 504 patients with mean±SD age of 79.37 ± 8.06 years. Multivariate analysis showed that traffic accident, GCS score of 14/15, transient consciousness loss, nausea, and receipt of antiplatelets were predictors of ICL, while SRRI and/or benzodiazepine intake was a protective factor. A score was assigned to patients by rounding OR values, and a score ≥1 indicated moderate/high risk of ICL. Conclusions: MTBI management should be distinct in over-60 year-olds, who may not present typical symptoms, with frequent comorbidities. Knowledge of risk factors for post-MTBI ICL, associated with higher mortality, is important to support clinical decision-making. Further research is warranted to verify our novel finding that benzodiazepines and/or SSRI inhibitors may act as neuroprotectors.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0269-9052 1362-301X
DOI:	10.1080/02699052.2017.1382716