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One-year outcome following brain injury: a comparison of younger versus elderly major trauma patients

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The increasing number of older trauma patients has provoked a debate on the need for subsequent rehabilitative therapy for the elderly. Our findings revealed a lack of detailed data on this topic so we became interested in the effective differences in the longer-term outcomes for older and younger major trauma patients with TBI. As validation studies on the recently published specific Quality of Life after Brain Injury (QOLIBRI) have only involved patients under the age of 68 years, we focused on testing this score in comparison to other outcome measures.

Materials and methods

Prospective cohort study of the differences in 1-year functional or health-related quality of life (HRQoL) outcomes, such as the Glasgow Outcome Score (GOS), the Quality of Life after Brain Injury (QOLIBRI) score or the medical outcomes study Short Form-36 (SF-36) between younger (16–64 years) and elderly (> 65 years) adults following major trauma (New Injury Severity Score, NISS ≥ 8) with TBI (Abbreviated Injury Scale, AIS head > 0).

Results

Out of 326 TBI patients with a mean NISS of 20.6 ± 9.4 34% (n = 110 (33.7%)) were aged 65 or older versus n = 216 (66.3%) who were younger. Comparison of 1-year outcomes revealed no differences between younger versus elderly patients with regard to functional or HRQoL scores (e.g. total QOLIBRI 77.4 ± 20.0 and 75.6 ± 18.1, resp.). Univariate analysis showed no correlation of the total QOLIBRI with age (Pearson r = − 0.09) or trauma severity (AIS) of the head (r = − 0.05). Multivariate analysis confirmed an association of age 80 or older (R2 = 0.026, p = 0.029), but not of overall age (R2 = 0.004, p = 0.218) with 1-year outcome scores on the total QOLIBRI.

Conclusions

Given the rising rehabilitation demands of the elderly these pilot findings call for the utilisation of specific outcome scores such as the QOLIBRI in this age group as well, at least up to an age of 80 years and independently of the severity of TBI sustained.

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Acknowledgements

The authors are grateful for the commitment of L. Meier, F. Maeder, M. Keller and S. Morell in collecting original data, the editorial assistance of J. Buchanan and thank all the patients and interdisciplinary hospital collaborators involved in the study.

Funding

The study was financially supported by the Research Fund of the hospital.

Author information

Authors and Affiliations

  1. Trauma Unit, Department of Surgery, Cantonal Hospital Aarau, Tellstrasse 1, 5001, Aarau, Switzerland

    Thomas Gross

  2. Basel, Switzerland

    Felix Amsler

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  1. Thomas Gross
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Correspondence to Thomas Gross.

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The authors declare that there is no conflict of interest.

Ethical approval

The study has been approved by the regional ethics committee and has been performed in accordance with the ethical standards laid down in the Declaration of Helsinki.

Informed consent

All persons gave their informed consent prior to their inclusion in the study.

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Gross, T., Amsler, F. One-year outcome following brain injury: a comparison of younger versus elderly major trauma patients. Arch Orthop Trauma Surg 138, 1375–1387 (2018). https://doi.org/10.1007/s00402-018-2974-1

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