van der Vlegel, M, Mikolić, A, Lee Hee, Q, Kaplan, ZLR, Retel Helmrich, IRA, van Veen, E, Andelic, N, Steinbuechel, NV, Plass, AM, Zeldovich, M, Wilson, L, Maas, AIR
, Haagsma, JA, Polinder, S, Åkerlund, C, George, P, Lanyon, L, Muraleedharan, V, Nelson, D, Amrein, K, Ezer, E, Kovács, N, Melegh, BL, Nyirádi, JZ, Tamás, V, Vámos, Z, Sorinola, A, Andreassen, L, Anke, A, Frisvold, S, Antoni, A, Schwendenwein, E, Audibert, GR, Azouvi, P, Azzolini, ML, Beretta, L, Calvi, MR, Bartels, R, Boogert, HD, Barzó, PL, Beauvais, R, Perera, N, Beer, R, Helbok, R, Bellander, B-M, Belli, A, Benali, H, Degos, V, Galanaud, D, Perlbarg, V, Berardino, M, Cavallo, S, Blaabjerg, M, Rosenlund, C, Schou, RF, Bragge, P, Brazinova, A, Majdan, M, Taylor, MS, Zelinkova, V, Brinck, V, Jarrett, M, Brooker, J, Donoghue, E, Synnot, A, Brorsson, C, Koskinen, L-O, Sundström, N, Buki, A, Czeiter, E, Bullinger, M, Cabeleira, M, Czosnyka, M, Dixit, A, Ercole, A, Koraropoulos, E, Menon, D, Newcombe, V, Richter, S, Smielewski, P, Stamatakis, E, Williams, G, Winzeck, S, Zeiler, FA, Caccioppola, A, Calappi, E, Carbonara, M, Ortolano, F, Zoerle, T, Stocchetti, N, Cameron, P, Gantner, D, Murray, L, Trapani, T, Vallance, S, Lozano, GC, Pomposo, I, Castaño-León, AM, Gomez, PA, Lagares, A, Chevallard, G, Chieregato, A, Citerio, G, Vargiolu, A, Ceyisakar, I, Gravesteijn, B
, Huijben, J, Lingsma, H, Nieboer, D, Mikolic, A, Sewalt, C, Steyerberg, EW, Velt, K, Voormolen, D, Wiegers, E, Peul, W, van Dijck, JTJM, van Essen, TA, van Wijk, RPJ, Clusmann, H, Coburn, M, Kowark, A, Rossaint, R, Coles, J, Cooper, JD, Correia, M, Čovid, A, von Steinbüchel, N, Curry, N, Stanworth, S, Dahyot-Fizelier, C, Dark, P, Johnson, F, Dawes, H, Esser, P, van Heugten, C, de Keyser, VR, Menovsky, T, van der Steen, G, Corte, FD, Grossi, F, Depreitere, B, Đilvesi, Đ, Golubovic, J, Karan, M, Vulekovic, P, Dreier, J, Vajkoczy, P, Wolf, S, Dulière, G-L, Maréchal, H, Fabricius, M, Kondziella, D, Feigin, VL, Jones, K, Ao, BT, Theadom, A, Foks, K, Haitsma, I, Volovici, V, Furmanov, A, Rosenthal, G, Gagliardo, P, Gao, G, Jiang, J, Ghuysen, A, Giga, L, Valeinis, E, Ziverte, A, Glocker, B, Rueckert, D, Gratz, J, Gruen, RL, Gupta, D, Roe, C, Helseth, E, Roise, O, Horton, L, Hutchinson, PJ, Kolias, AG, Jacobs, B, van der Naalt, J, Jankowski, S, Kompanje, E, Timmers, M, Laureys, S, Ledoux, D, Misset, B, Lecky, F, Olubukola, O, Lefering, R, Schäfer, N, Legrand, V, Lejeune, A, Vega, E, Mattern, J, Levi, L, Lightfoot, R, Maegele, M, Manara, A, Thomas, M, Manley, G, Martino, C, Sakowitz, O, Sanchez-Porras, R, Younsi, A, McMahon, C, Negru, A, Oresic, M, Palotie, A, Parizel, PM, Payen, J-F, Persona, P, Piippo-Karjalainen, A, Pirinen, M, Ples, H, Posti, JP, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rosand, J, Rosenfeld, JV, Rossi, S, Rusnák, M, Sahuquillo, J, Sandor, J, Schmidt, S, Schoechl, H, Schoonman, G, Skandsen, T, Stevens, R, Stewart, W, Takala, R, Tamosuitis, T, Tenovuo, O, Tibboel, D, Tolias, C, Tudora, CM, van der Jagt, M, van Hecke, W, van Praag, D, Vyvere, TV, Verheyden, J, Vespa, PM, Vik, A, Vilcinis, R, Wang, KKW, Yang, Z & Ylén, P 2022, '
Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study',
Injury, vol. 53, no. 8, pp. 2774-2782.
https://doi.org/10.1016/j.injury.2022.05.009@article{0d41a7aee51449c4b03a33e4c8a1163e,
title = "Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study",
abstract = "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.",
keywords = "Health care utilization, Health-related quality of life, Mental health, Older adults, Outcomes, Traumatic Brain Injury",
author = "{van der Vlegel}, Marjolein and Ana Mikoli{\'c} and {Lee Hee}, Quentin and Kaplan, {Z. L. Rana} and {Retel Helmrich}, {Isabel R. A.} and {van Veen}, Ernest and Nada Andelic and Steinbuechel, {Nicole v.} and Plass, {Anne Marie} and Marina Zeldovich and Lindsay Wilson and Maas, {Andrew I. R.} and Haagsma, {Juanita A.} and Suzanne Polinder and Cecilia {\AA}kerlund and Pradeep George and Linda Lanyon and Visakh Muraleedharan and David Nelson and Krisztina Amrein and Erzs{\'e}bet Ezer and No{\'e}mi Kov{\'a}cs and Melegh, {B. la} and Nyir{\'a}di, {J. zsef} and Vikt{\'o}ria Tam{\'a}s and Zolt{\'a}n V{\'a}mos and Abayomi Sorinola and Lasse Andreassen and Audny Anke and Shirin Frisvold and Anna Antoni and Elisabeth Schwendenwein and Audibert, {G. rard} and Philippe Azouvi and Azzolini, {Maria Luisa} and Luigi Beretta and Calvi, {Maria Rosa} and Ronald Bartels and Boogert, {Hugo den} and Barz{\'o}, {P. l} and Romuald Beauvais and Natascha Perera and Ronny Beer and Raimund Helbok and Bo-Michael Bellander and Antonio Belli and Habib Benali and Vincent Degos and Damien Galanaud and Vincent Perlbarg and Maurizio Berardino and Simona Cavallo and Morten Blaabjerg and Christina Rosenlund and Schou, {Rico Frederik} and Peter Bragge and Alexandra Brazinova and Marek Majdan and Taylor, {Mark Steven} and Veronika Zelinkova and Vibeke Brinck and Mike Jarrett and Joanne Brooker and Emma Donoghue and Anneliese Synnot and Camilla Brorsson and Lars-Owe Koskinen and Nina Sundstr{\"o}m and Andras Buki and Endre Czeiter and Monika Bullinger and Manuel Cabeleira and Marek Czosnyka and Abhishek Dixit and Ari Ercole and Evgenios Koraropoulos and David Menon and Virginia Newcombe and Sophie Richter and Peter Smielewski and Emmanuel Stamatakis and Guy Williams and Stefan Winzeck and Zeiler, {Frederick A.} and Alessio Caccioppola and Emiliana Calappi and Marco Carbonara and Fabrizio Ortolano and Tommaso Zoerle and Nino Stocchetti and Peter Cameron and Dashiell Gantner and Lynnette Murray and Tony Trapani and Shirley Vallance and Lozano, {Guillermo Carbayo} and Inigo Pomposo and Casta{\~n}o-Le{\'o}n, {Ana M.} and Gomez, {Pedro A.} and Alfonso Lagares and Giorgio Chevallard and Arturo Chieregato and Giuseppe Citerio and Alessia Vargiolu and Iris Ceyisakar and Benjamin Gravesteijn and Jilske Huijben and Hester Lingsma and Daan Nieboer and Ana Mikolic and Charlie Sewalt and Steyerberg, {Ewout W.} and Kimberley Velt and Daphne Voormolen and Eveline Wiegers and Wilco Peul and {van Dijck}, {Jeroen T. J. M.} and {van Essen}, {Thomas A.} and {van Wijk}, {Roel P. J.} and Hans Clusmann and Mark Coburn and Ana Kowark and Rolf Rossaint and Jonathan Coles and Cooper, {Jamie D.} and Marta Correia and Amra {\v C}ovid and {von Steinb{\"u}chel}, Nicole and Nicola Curry and Simon Stanworth and Claire Dahyot-Fizelier and Paul Dark and Faye Johnson and Helen Dawes and Patrick Esser and {van Heugten}, Caroline and {de Keyser}, {V. ronique} and Tomas Menovsky and {van der Steen}, Gregory and Corte, {Francesco Della} and Francesca Grossi and Bart Depreitere and {\D}ula {\D}ilvesi and Jago{\v s} Golubovic and Mladen Karan and Petar Vulekovic and Jens Dreier and Peter Vajkoczy and Stefan Wolf and Guy-Loup Duli{\`e}re and Hugues Mar{\'e}chal and Martin Fabricius and Daniel Kondziella and Feigin, {Valery L.} and Kelly Jones and Ao, {Braden Te} and Alice Theadom and Kelly Foks and Iain Haitsma and Victor Volovici and Alex Furmanov and Guy Rosenthal and Pablo Gagliardo and Guoyi Gao and Ji-yao Jiang and Alexandre Ghuysen and Lelde Giga and Egils Valeinis and Agate Ziverte and Ben Glocker and Daniel Rueckert and Johannes Gratz and Gruen, {Russell L.} and Deepak Gupta and Cecilie Roe and Eirik Helseth and Olav Roise and Lindsay Horton and Hutchinson, {Peter J.} and Kolias, {Angelos G.} and Bram Jacobs and {van der Naalt}, Joukje and Stefan Jankowski and Erwin Kompanje and Marjolein Timmers and Steven Laureys and Didier Ledoux and Benoit Misset and Fiona Lecky and Otesile Olubukola and Rolf Lefering and Nadine Sch{\"a}fer and Valerie Legrand and Aurelie Lejeune and Emmanuel Vega and Julia Mattern and Leon Levi and Roger Lightfoot and Marc Maegele and Alex Manara and Matt Thomas and Geoffrey Manley and Costanza Martino and Oliver Sakowitz and Renan Sanchez-Porras and Alexander Younsi and Catherine McMahon and Ancuta Negru and Matej Oresic and Aarno Palotie and Parizel, {Paul M.} and Jean-Fran{\c c}ois Payen and Paolo Persona and Anna Piippo-Karjalainen and Matti Pirinen and Horia Ples and Posti, {Jussi P.} and Louis Puybasset and Andreea Radoi and Arminas Ragauskas and Rahul Raj and Malinka Rambadagalla and Jonathan Rhodes and Sylvia Richardson and Samuli Ripatti and Saulius Rocka and Jonathan Rosand and Rosenfeld, {Jeffrey V.} and Sandra Rossi and Martin Rusn{\'a}k and Juan Sahuquillo and Janos Sandor and Silke Schmidt and Herbert Schoechl and Guus Schoonman and Toril Skandsen and Robert Stevens and William Stewart and Riikka Takala and Tomas Tamosuitis and Olli Tenovuo and Dick Tibboel and Christos Tolias and Tudora, {Cristina Maria} and {van der Jagt}, Mathieu and {van Hecke}, Wim and {van Praag}, Dominique and Vyvere, {Thijs Vande} and Jan Verheyden and Vespa, {Paul M.} and Anne Vik and Rimantas Vilcinis and Wang, {Kevin K. W.} and Zhihui Yang and Peter Yl{\'e}n",
note = "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: {\textcopyright} 2022",
year = "2022",
month = aug,
doi = "10.1016/j.injury.2022.05.009",
language = "English",
volume = "53",
pages = "2774--2782",
journal = "Injury",
issn = "0020-1383",
publisher = "Elsevier Limited",
number = "8",
}
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 - Mikolić, 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 - Åkerlund, Cecilia
AU - George, Pradeep
AU - Lanyon, Linda
AU - Muraleedharan, Visakh
AU - Nelson, David
AU - Amrein, Krisztina
AU - Ezer, Erzsébet
AU - Kovács, Noémi
AU - Melegh, B. la
AU - Nyirádi, J. zsef
AU - Tamás, Viktória
AU - Vámos, Zoltán
AU - Sorinola, Abayomi
AU - Andreassen, Lasse
AU - Anke, Audny
AU - Frisvold, Shirin
AU - Antoni, Anna
AU - Schwendenwein, Elisabeth
AU - Audibert, G. rard
AU - Azouvi, Philippe
AU - Azzolini, Maria Luisa
AU - Beretta, Luigi
AU - Calvi, Maria Rosa
AU - Bartels, Ronald
AU - Boogert, Hugo den
AU - Barzó, P. l
AU - Beauvais, Romuald
AU - Perera, Natascha
AU - Beer, Ronny
AU - Helbok, Raimund
AU - Bellander, Bo-Michael
AU - Belli, Antonio
AU - Benali, Habib
AU - Degos, Vincent
AU - Galanaud, Damien
AU - Perlbarg, Vincent
AU - Berardino, Maurizio
AU - Cavallo, Simona
AU - Blaabjerg, Morten
AU - Rosenlund, Christina
AU - Schou, Rico Frederik
AU - Bragge, Peter
AU - Brazinova, Alexandra
AU - Majdan, Marek
AU - Taylor, Mark Steven
AU - Zelinkova, Veronika
AU - Brinck, Vibeke
AU - Jarrett, Mike
AU - Brooker, Joanne
AU - Donoghue, Emma
AU - Synnot, Anneliese
AU - Brorsson, Camilla
AU - Koskinen, Lars-Owe
AU - Sundström, Nina
AU - Buki, Andras
AU - Czeiter, Endre
AU - Bullinger, Monika
AU - Cabeleira, Manuel
AU - Czosnyka, Marek
AU - Dixit, Abhishek
AU - Ercole, Ari
AU - Koraropoulos, Evgenios
AU - Menon, David
AU - Newcombe, Virginia
AU - Richter, Sophie
AU - Smielewski, Peter
AU - Stamatakis, Emmanuel
AU - Williams, Guy
AU - Winzeck, Stefan
AU - Zeiler, Frederick A.
AU - Caccioppola, Alessio
AU - Calappi, Emiliana
AU - Carbonara, Marco
AU - Ortolano, Fabrizio
AU - Zoerle, Tommaso
AU - Stocchetti, Nino
AU - Cameron, Peter
AU - Gantner, Dashiell
AU - Murray, Lynnette
AU - Trapani, Tony
AU - Vallance, Shirley
AU - Lozano, Guillermo Carbayo
AU - Pomposo, Inigo
AU - Castaño-León, Ana M.
AU - Gomez, Pedro A.
AU - Lagares, Alfonso
AU - Chevallard, Giorgio
AU - Chieregato, Arturo
AU - Citerio, Giuseppe
AU - Vargiolu, Alessia
AU - Ceyisakar, Iris
AU - Gravesteijn, Benjamin
AU - Huijben, Jilske
AU - Lingsma, Hester
AU - Nieboer, Daan
AU - Mikolic, Ana
AU - Sewalt, Charlie
AU - Steyerberg, Ewout W.
AU - Velt, Kimberley
AU - Voormolen, Daphne
AU - Wiegers, Eveline
AU - Peul, Wilco
AU - van Dijck, Jeroen T. J. M.
AU - van Essen, Thomas A.
AU - van Wijk, Roel P. J.
AU - Clusmann, Hans
AU - Coburn, Mark
AU - Kowark, Ana
AU - Rossaint, Rolf
AU - Coles, Jonathan
AU - Cooper, Jamie D.
AU - Correia, Marta
AU - Čovid, Amra
AU - von Steinbüchel, Nicole
AU - Curry, Nicola
AU - Stanworth, Simon
AU - Dahyot-Fizelier, Claire
AU - Dark, Paul
AU - Johnson, Faye
AU - Dawes, Helen
AU - Esser, Patrick
AU - van Heugten, Caroline
AU - de Keyser, V. ronique
AU - Menovsky, Tomas
AU - van der Steen, Gregory
AU - Corte, Francesco Della
AU - Grossi, Francesca
AU - Depreitere, Bart
AU - Đilvesi, Đula
AU - Golubovic, Jagoš
AU - Karan, Mladen
AU - Vulekovic, Petar
AU - Dreier, Jens
AU - Vajkoczy, Peter
AU - Wolf, Stefan
AU - Dulière, Guy-Loup
AU - Maréchal, Hugues
AU - Fabricius, Martin
AU - Kondziella, Daniel
AU - Feigin, Valery L.
AU - Jones, Kelly
AU - Ao, Braden Te
AU - Theadom, Alice
AU - Foks, Kelly
AU - Haitsma, Iain
AU - Volovici, Victor
AU - Furmanov, Alex
AU - Rosenthal, Guy
AU - Gagliardo, Pablo
AU - Gao, Guoyi
AU - Jiang, Ji-yao
AU - Ghuysen, Alexandre
AU - Giga, Lelde
AU - Valeinis, Egils
AU - Ziverte, Agate
AU - Glocker, Ben
AU - Rueckert, Daniel
AU - Gratz, Johannes
AU - Gruen, Russell L.
AU - Gupta, Deepak
AU - Roe, Cecilie
AU - Helseth, Eirik
AU - Roise, Olav
AU - Horton, Lindsay
AU - Hutchinson, Peter J.
AU - Kolias, Angelos G.
AU - Jacobs, Bram
AU - van der Naalt, Joukje
AU - Jankowski, Stefan
AU - Kompanje, Erwin
AU - Timmers, Marjolein
AU - Laureys, Steven
AU - Ledoux, Didier
AU - Misset, Benoit
AU - Lecky, Fiona
AU - Olubukola, Otesile
AU - Lefering, Rolf
AU - Schäfer, Nadine
AU - Legrand, Valerie
AU - Lejeune, Aurelie
AU - Vega, Emmanuel
AU - Mattern, Julia
AU - Levi, Leon
AU - Lightfoot, Roger
AU - Maegele, Marc
AU - Manara, Alex
AU - Thomas, Matt
AU - Manley, Geoffrey
AU - Martino, Costanza
AU - Sakowitz, Oliver
AU - Sanchez-Porras, Renan
AU - Younsi, Alexander
AU - McMahon, Catherine
AU - Negru, Ancuta
AU - Oresic, Matej
AU - Palotie, Aarno
AU - Parizel, Paul M.
AU - Payen, Jean-François
AU - Persona, Paolo
AU - Piippo-Karjalainen, Anna
AU - Pirinen, Matti
AU - Ples, Horia
AU - Posti, Jussi P.
AU - Puybasset, Louis
AU - Radoi, Andreea
AU - Ragauskas, Arminas
AU - Raj, Rahul
AU - Rambadagalla, Malinka
AU - Rhodes, Jonathan
AU - Richardson, Sylvia
AU - Ripatti, Samuli
AU - Rocka, Saulius
AU - Rosand, Jonathan
AU - Rosenfeld, Jeffrey V.
AU - Rossi, Sandra
AU - Rusnák, Martin
AU - Sahuquillo, Juan
AU - Sandor, Janos
AU - Schmidt, Silke
AU - Schoechl, Herbert
AU - Schoonman, Guus
AU - Skandsen, Toril
AU - Stevens, Robert
AU - Stewart, William
AU - Takala, Riikka
AU - Tamosuitis, Tomas
AU - Tenovuo, Olli
AU - Tibboel, Dick
AU - Tolias, Christos
AU - Tudora, Cristina Maria
AU - van der Jagt, Mathieu
AU - van Hecke, Wim
AU - van Praag, Dominique
AU - Vyvere, Thijs Vande
AU - Verheyden, Jan
AU - Vespa, Paul M.
AU - Vik, Anne
AU - Vilcinis, Rimantas
AU - Wang, Kevin K. W.
AU - Yang, Zhihui
AU - Ylén, Peter
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 - 2022/8
Y1 - 2022/8
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
VL - 53
SP - 2774
EP - 2782
JO - Injury
JF - Injury
SN - 0020-1383
IS - 8
ER -