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Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study

Elsevier BV; Volume: 53; Issue: 8 Linguagem: Inglês

10.1016/j.injury.2022.05.009

1879-0267

Marjolein van der Vlegel, Ana Mikolić, Quentin Lee Hee, Z Kaplan, Isabel R. A. Retel Helmrich, Ernest van Veen, Nada Anđelić, Nicole von Steinbüechel, Anne Marie Plass, Marina Zeldovich, Lindsay Wilson, Andrew I.R. Maas, Juanita A. Haagsma, Suzanne Polinder, Cecilia A ̊ kerlund, Pradeep George, Linda Lanyon, Visakh Muraleedharan, David Nelson, Krisztina Amrein, Erzsébet Ezer, Noémi Kovács, Béla Melegh, József Nyirádi, Viktória Tamás, Zoltán Vámos, Abayomi Sorinola, Nada Anđelić, Lasse Andreassen, Audny Anke, Shirin Frisvold, Anna Antoni, Elisabeth Schwendenwein, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Luigi Beretta, Maria Rosa Calvi, Ronald Bartels, Hugo den Boogert, Pál Barzó, Romuald Beauvais, Natascha Perera, Ronny Beer, Raimund Helbok, Bo‐Michael Bellander, Antonio Belli, Habib Benali, Vincent Degos, Damien Galanaud, Vincent Perlbarg, Maurizio Berardino, Simona Cavallo, Morten Blaabjerg, Christina Rosenlund, Rico Frederik Schou, Peter Bragge, Alexandra Bražinová, Marek Majdán, Mark Taylor, Veronika Zelinkova, Vibeke Brinck, Mike Jarrett, Joanne Brooker, Emma Donoghue, Anneliese Synnot, Camilla Brorsson, Lars‐Owe Koskinen, Nina Sundström, András Büki, Endre Czeiter, Monika Bullinger, Manuel Cabeleira, Marek Czosnyka, Abhishek Dixit, Ari Ercole, Evgenios Koraropoulos, David K. Menon, Virginia Newcombe, Sophie Richter, Peter Smielewski, Emmanuel A. Stamatakis, Guy Williams, Stefan Winzeck, Frederick A. Zeiler, Alessio Caccioppola, Emiliana Calappi, Marco Carbonara, Fabrizio Ortolano, Tommaso Zoerle, Nino Stocchetti, Peter Cameron, Dashiell Gantner, Lynnette Murray, Tony Trapani, Shirley Vallance, Guillermo Carbayo Lozano, Iñigo Pomposo, Ana M. Castaño‐León, Pedro A. Gómez, Alfonso Lagares, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Alessia Vargiolu, Iris Ceyisakar, Benjamin Gravesteijn, Juanita A. Haagsma, Jilske Huijben, Hester F. Lingsma, Daan Nieboer, Ana Mikolić, Suzanne Polinder, Charlie Sewalt, Ewout W. Steyerberg, Kimberley Velt, Daphne Voormolen, Eveline Wiegers, Wilco C. Peul, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Roel P. J. van Wijk, Hans Clusmann, Mark Coburn, Ana Kowark, Rolf Rossaint, Jonathan Coles, D. James Cooper, Marta Correia, Amra Cˇovid, Nicole von Steinbüchel, Nicola Curry, Simon Stanworth, Claire Dahyot‐Fizelier, Paul Dark, Faye Johnson, Helen Dawes, Patrick Esser, Caroline van Heugten, Véronique De Keyser, Andrew I.R. Maas, Tomas Menovsky, Gregory Van der Steen, Françesco Della Corte, Francesca Grossi, Bart Depreitere, Đula Đilvesi, Jagoš Golubović, Mladen Karan, Petar Vuleković, Jens P. Dreier, Peter Vajkoczy, Stefan Wolf, Guy‐Loup Dulière, Hugues Maréchal, Martin Fabricius, Daniel Kondziella, Valery L. Feigin, Kelly Jones, Braden Te Ao, Alice Theadom, Kelly Foks, Iain Haitsma, Victor Volovici, Alex Furmanov, Guy Rosenthal, Pablo Gagliardo, Guoyi Gao, Jiyao Jiang, Alexandre Ghuysen, Lelde Giga, Egils Valeinis, Agate Ziverte, Ben Glocker, Daniel Rueckert, Johannes Gratz, Russell L. Gruen, Deepak Gupta, Cecilie Røe, Eirik Helseth, Olav Røise, Lindsay Horton, Lindsay Wilson, Peter J. Hutchinson, Angelos G. Kolias, Bram Jacobs, Joukje van der Naalt, Stefan Jankowski, Erwin J. O. Kompanje, Marjolein Timmers, Steven Laureys, Didier Ledoux, Benoît Misset, Fiona Lecky, Otesile Olubukola, Rolf Lefering, Nadine Schäfer, Valérie Legrand, Aurélie Lejeune, Emmanuel Vega, Julia Mattern, Leon Levi, Roger Lightfoot, Marc Maegele, Alex Manara, Matt Thomas, Geoffrey T. Manley, Costanza Martino, Oliver Sakowitz, Renán Sánchez-Porras, Alexander Younsi, Catherine McMahon, Ancuța Negru, Matej Orešič, Aarno Palotie, Paul M. Parizel, Jean‐François Payen, Paolo Persona, Anna Piippo-Karjalainen, Matti Pirinen, Horia Pleș, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan R. Rhodes, Sylvia Richardson, Samuli Ripatti, Saulius Ročka, Jonathan Rosand, Jeffrey V. Rosenfeld, Sandra Rossi, Martin Rusňák, Juan Sahuquillo, János Sándor, Silke Schmidt, Herbert Schöechl, Guus Schoonman, Toril Skandsen, Robert D. Stevens, William Stewart, Riikka Takala, Tomas Tamošuitis, Olli Tenovuo, Dick Tibboel, Christos Tolias, Cristina Maria Tudora, Mathieu van der Jagt, Wim Van Hecke, Dominique Van Praag, Thijs Vande Vyvere, Jan Verheyden, Paul Vespa, Anne Vik, Rimantas Vilcinis, Kevin Wang, Zhihui Yang, Peter Ylén,

Traumatic Brain Injury Research

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.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.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.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.