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

• 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
• DOI: 10.1080/02699052.2017.1382716
• EISSN: 1362-301X
• ISSN: 0269-9052

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.