TY - JOUR
T1 - Health care utilization and outcomes in older adults after Traumatic Brain Injury
T2 - A CENTER-TBI study
AU - van der Vlegel, Marjolein
AU - Mikolic, Ana
AU - Lee Hee, Quentin
AU - Kaplan, Z. L.Rana
AU - Retel Helmrich, Isabel R.A.
AU - van Veen, Ernest
AU - Andelic, Nada
AU - Steinbuechel, Nicole v.
AU - Plass, Anne Marie
AU - Zeldovich, Marina
AU - Wilson, Lindsay
AU - Maas, Andrew I.R.
AU - Haagsma, Juanita A.
AU - Polinder, Suzanne
AU - Bragge, Peter
AU - Brooker, Joanne
AU - Donoghue, Emma
AU - Synnot, Anneliese
AU - Cameron, Peter
AU - Gantner, Dashiell
AU - Murray, Lynnette
AU - Trapani, Tony
AU - Vallance, Shirley
AU - Wiegers, Eveline
AU - Cooper, Jamie D.
AU - Gruen, Russell L.
AU - Lecky, Fiona
AU - Rosenfeld, Jeffrey V.
AU - the CENTER-TBI investigators and participants
N1 - Funding Information:
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).
Funding Information:
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) .
Publisher Copyright:
© 2022
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Health care utilization
KW - Health-related quality of life
KW - Mental health
KW - Older adults
KW - Outcomes
KW - Traumatic Brain Injury
UR - http://www.scopus.com/inward/record.url?scp=85132842261&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2022.05.009
DO - 10.1016/j.injury.2022.05.009
M3 - Article
C2 - 35725508
AN - SCOPUS:85132842261
SN - 0020-1383
VL - 53
SP - 2774
EP - 2782
JO - Injury
JF - Injury
ER -
