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Prevalence and Outcomes of Geriatric Traumatic Brain Injury in Developing Countries: A Retrospective Study
Introduction The world populace is aging and it is anticipated that 2 billion people will be older than 60 years by 2050. Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In the United States, 2.8 million people pursue medical attention yearly. TBI exemplifies a leading cause of mortality and morbidity among the geriatric age group worldwide.
Methods A retrospective study of geriatric cases who were admitted to the Neurosurgery Department in Khoula Hospital from January 1, 2016, to December 31, 2019, was conducted. Patients' demographics, risk factors, neuro-vital sign, diagnosis, Glasgow coma scale (GCS) on arrival, treatment types, and length of stay (LOS) were recorded.
Results Two hundred and thirty-four patients were admitted due to TBI in four years period. Seventy-five percent of the study cohort were more than 75 years old. Male to female ratio was 2.4:1. Subdural hematoma (SDH) was the most common TBI diagnosis based on computed tomography (77.4%). Most of the patients were having GCS scores of 14 to 15 (67.9%). Sixteen percent of the patients received antiepileptic medications. The majority of the patients underwent surgical intervention (70.5%). Eighty percent of the patients stayed in the hospital for less than 15 days. There was a significant difference between the LOS and type of surgery. Subarachnoid hemorrhage was found to have the highest mean age (79.7 years). Intracerebral hemorrhage patients had the longest LOS in the hospital with a mean of 44.2 days. There was no significant difference between the age of patients and type of surgery.
Conclusion The number of TBI in the elderly population is increasing annually. The most common type of TBI in our cohort was SDH and most of the patients were treated with burr hole surgery.
Article published online:
20 September 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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- 1 Gardner RC, Dams-O'Connor K, Morrissey MR, Manley GT. Geriatric traumatic brain injury: epidemiology, outcomes, knowledge gaps, and future directions. J Neurotrauma 2018; 35 (07) 889-906
- 2 Marrone F, Zavatto L, Allevi M. et al. Management of mild brain trauma in the elderly: literature review. Asian J Neurosurg 2020; 15 (04) 809-820
- 3 Zeng X, Pan S, Hu Z. Geriatric traumatic brain injury in China. Curr Transl Geriatr Exp Gerontol Rep 2012; 1 (03) 167-170
- 4 Prasad GL, Anmol N, Menon GR. Outcome of traumatic brain injury in the elderly population: a tertiary center experience in a developing country. World Neurosurg 2018; 111: e228-e234
- 5 Lee B, Newberg A. Neuroimaging in traumatic brain imaging. NeuroRx 2005; 2 (02) 372-383
- 6 Peters ME, Gardner RC. Traumatic brain injury in older adults: do we need a different approach?. Concussion 2018; 3 (03) CNC56 10.2217/cnc-2018-0001
- 7 Thompson HJ, McCormick WC, Kagan SH. Traumatic brain injury in older adults: epidemiology, outcomes, and future implications. J Am Geriatr Soc 2006; 54 (10) 1590-1595 x
- 8 O'Neil ME, Carlson K, Storzbach D. et al. Complications of Mild Traumatic Brain Injury in Veterans and Military Personnel: A Systematic Review [Internet]. Washington, DC: Department of Veterans Affairs (US); 2013
- 9 The World Health Report 2000 (Health Systems: Improving Performance). WHO Geneva. Available at: https://www.who.int/whr/2000/en/
- 10 Al-Kalbani H, Al-Saadi T, Al-Kumzari A, Al-Bahrani H. Public's perception and satisfaction on the health care system in Sultanate of Oman: a cross-sectional study. Ann Natl Acad Med Sci 2020; 56 (04) 214-219
- 11 Mishra GP, Saadi TA, Salhotra N. et al. Brain and spinal tumors incidence annual audit 2017 of Dept of Neurosurgery Khoula Hospital Muscat Oman: a review. Am J Med Case Rep 2018; 6 (07) 128-131
- 12 Al-Saadi T, Al Sharqi A, Al Sharqi J. et al. Leaving against medical advice among patients with brain tumours in the Middle East: Khoula Hospital experience. Int Clin Neurosci J 2020; 7 (04) 179-184
- 13 The Statistical Centre for the Cooperation Council for the Arab Countries of the Gulf (“GCC-Stat”) Accessed September first 2021. https://gccstat.org/en/
- 14 World Health Organization. The World Health Report 2008 (2008) Primary Health Care—Now More Than Ever. Geneva, Switzerland: World Health Organization;
- 15 Yokobori S, Yamaguchi M, Igarashi Y. et al. Outcome and refractory factor of intensive treatment for geriatric traumatic brain injury: analysis of 1165 cases registered in the Japan Neurotrauma Data Bank. World Neurosurg 2016; 86: 127-133.e1
- 16 Susman M, DiRusso SM, Sullivan T. et al. Traumatic brain injury in the elderly: increased mortality and worse functional outcome at discharge despite lower injury severity. J Trauma 2002; 53 (02) 219-223 , discussion 223–224 [discussion: 223–224]
- 17 Shapey J, Glancz LJ, Brennan PM. Chronic subdural haematoma in the elderly: is it time for a new paradigm in management?. Curr Geriatr Rep 2016; 5: 71-77
- 18 Uno M, Toi H, Hirai S. Chronic subdural hematoma in elderly patients: is this disease benign?. Neurol Med Chir (Tokyo) 2017; 57 (08) 402-409
- 19 Almenawer SA, Farrokhyar F, Hong C. et al. Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients. Ann Surg 2014; 259 (03) 449-457
- 20 Dash HH, Chavali S. Management of traumatic brain injury patients. Korean J Anesthesiol 2018; 71 (01) 12-21
- 21 Tardif PA, Moore L, Boutin A. et al. Hospital length of stay following admission for traumatic brain injury in a Canadian integrated trauma system: a retrospective multicenter cohort study. Injury 2017; 48 (01) 94-100
- 22 Campiglio L, Bianchi F, Cattalini C. et al. Mild brain injury and anticoagulants: less is enough. Neurol Clin Pract 2017; 7 (04) 296-305