Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study.

Health care utilization; Health-related quality of life; Mental health; Older adults; Outcomes; Traumatic Brain Injury; Aged; Glasgow Outcome Scale; Humans; Patient Acceptance of Health Care; Prospective Studies; Brain Injuries, Traumatic; Quality of Life/psychology; Quality of Life; Emergency Medicine; Orthopedics and Sports Medicine

Abstract :

[en] [en] 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.

Disciplines :

Anesthesia & intensive care

Author, co-author :

van der Vlegel, Marjolein; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands. Electronic address: m.vandervlegel@erasmusmc.nl

Mikolić, Ana; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands

Lee Hee, Quentin; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands

Kaplan, Z L Rana; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands

Retel Helmrich, Isabel R A; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands

van Veen, Ernest; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands, Department of Intensive Care Adults, Rotterdam, the Netherlands

Andelic, Nada; Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, 0424 Oslo, Norway

Steinbuechel, Nicole V; Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany

Plass, Anne Marie; Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany

Zeldovich, Marina; Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany

More authors (5 more)

Other collaborator :

Misset, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs

Language :

English

Title :

Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study.

Publication date :

August 2022

Journal title :

Injury

ISSN :

0020-1383

eISSN :

1572-3461

Publisher :

Elsevier Ltd, Netherlands

Volume :

Issue :

Pages :

2774 - 2782

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0020138322003291?httpAccept=text/xml

European Projects :

FP7 - 602150 - CENTER-TBI - Collaborative European NeuroTrauma Effectiveness Research in TBI

Funders :

EU - European Union [BE]

Funding text :

CENTER-TBI was supported by the European Union 7th Framework program (EC Grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA) and from Integra LifeSciences Corporation (USA).CENTER-TBI was supported by the European Union 7th Framework program ( EC Grant 602150 ). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA) and from Integra LifeSciences Corporation (USA) .

Available on ORBi :

since 07 July 2023

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