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A meta-analysis of functional outcome among older adults with traumatic brain injury
Amanda McIntyre1, Swati Mehta, Shannon Janzen
1Lawson Health Research Institute, St. Joseph's Parkwood Hospital, London, ON, Canada.
Objective:
The objective of this study was to determine rates of functional outcomes, based on Glasgow Outcome Scale scores, among older adults (>60 years) after a traumatic brain injury.
Methods:
An extensive database search was conducted. To be included all articles were published in English, included individuals 60 years or older, explicitly stated in-hospital GCS scores and GOS scores within one year post-TBI. Data was pooled on patient characteristics, mortality rates, time to death, and study design.
Results:
A total of 11 studies were included in this review. Among individuals with severe TBI, favourable, unfavourable, and fatal outcomes were observed in 7.9% (CI 5.3%-11.8%), 13.8% (CI 10.0%-18.8%) and 79.3% (CI 73.2%-84.4%), respectively. Among those with moderate TBI, favourable, unfavourable, and fatal outcomes were observed in 32.2% (CI 18.0%-50.7%), 29.5% (CI 16.5%-47.0%), and 42.5% (CI 26.1%-60.7%), respectively. Among those with mild TBI, favourable, unfavourable, and fatal outcomes were observed in 80.5% (CI 53.2%-93.7%), 7.0% (CI 1.9%-22.7%), and 10.7% (CI 3.1%-30.9%), respectively.
Conclusion:
This study has demonstrated the significant interaction between GCS and GOS among older adults. Although older adults may require aggressive and comprehensive treatment to achieve these favourable outcomes, high rates of unfavourable outcome should not justify the use of conservative treatment.
