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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Asian+J+Neurosurg 2017 ; 12 (1): 37-43 Nephropedia Template TP
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Outcome after operative intervention for traumatic brain injuries in the elderly #MMPMID28413530
Li LF; Lui WM; Wong HHT; Yuen WK; Leung GKK
Asian J Neurosurg 2017[Jan]; 12 (1): 37-43 PMID28413530show ga
Introduction:: The management of traumatic brain injuries in the elderly (age ? 65 years) is a constant dilemma. The aim of this study is to investigate for factors that may predict outcome of operative treatment in this group of patients. Materials and Methods:: A retrospective analysis was conducted on 68 elderly patients who had been operated in a designated center from 2006 to 2010. Patients? age, Glasgow Coma score (GCS), pupillary responses, imaging findings, medical conditions, and the use of anticoagulant/antiplatelet agents on patient outcomes were studied. Results:: The overall mortality rate was 55.9%. Older age, abnormal pupillary response, low GCS, the presence of midline shift and cistern obliteration on computerized tomography were associated with poor survival. Patient aged 75-84 with normal bilateral pupillary response still had an overall survival rate of 52.6% and good outcomes (Glasgow outcome score: 4 or 5) in 36.8% of patients. Abnormal pupillary response in at least one eye and preoperative GCS ? 12 were associated with very poor prognosis. Conclusions:: More advanced age was found to be associated with progressively worse outcome. A subgroup patients aged below 85 would survive and could achieve good clinical outcome. The prognosis of those aged over 85 with moderate or severe head injuries was extremely poor.