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Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Traumatic brain injury in an aging population
Nino Stocchetti1, Rosalia Paternò, Giuseppe Citerio
1University of Milan, NeuroIntensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy. stocchet@policinico.mi.it
Journal of Neurotrauma
|January 7, 2012
Summary
Elderly patients increasingly suffer traumatic brain injuries (TBI), with older age and poorer pre-injury health worsening outcomes. Intensive care can still yield favorable results for some older TBI survivors.
Area of Science:
- Neurosurgery
- Intensive Care Medicine
- Epidemiology
Background:
- Traumatic brain injury (TBI) epidemiology is shifting towards an older demographic in Western nations.
- Elderly patients admitted to neuro-intensive care units (neuro-ICUs) often present with worse pre-existing health conditions.
Purpose of the Study:
- To analyze the characteristics and outcomes of elderly patients with traumatic brain injury.
- To identify factors influencing outcomes in different age groups following TBI.
Main Methods:
- Retrospective analysis of 1366 adult patients admitted to three neuro-ICUs.
- Assessment of pre-trauma health status using APACHE scores.
- Classification of outcomes using the Glasgow Outcome Scale (GOS) at 6 months post-trauma.
Main Results:
- 44% of TBI patients were aged 50 or older, with older patients having worse pre-injury health.
- Subdural hematomas were more common in older patients, while extradural hematomas were more frequent in younger patients.
- Favorable outcomes (GOS 4-5) occurred in 50% of all patients, but decreased with age; mortality was higher in older patients.
Conclusions:
- Age and pre-existing health status are significant independent predictors of poor outcomes in TBI patients.
- While outcomes decline with age, intensive care and early surgical intervention can still offer benefits for older TBI patients, including those aged 60-69.
- The increasing proportion of elderly TBI patients necessitates tailored management strategies in neuro-ICUs.
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