The Influence of Age on the Outcomes of Traumatic Brain Injury

Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)

J-ASPECT Study Collaborators

Research output: Contribution to journalArticle

Abstract

Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

Original languageEnglish
JournalWorld neurosurgery
DOIs
Publication statusPublished - 2019 Jan 1

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Hospital Mortality
Odds Ratio
Surveys and Questionnaires
Traumatic Brain Injury
Length of Stay
Brain Concussion
Hematoma, Subdural, Acute
Sex Ratio
Coma
Consciousness
Nervous System
Japan
Epidemiology
Demography
Databases
Incidence

Keywords

  • Aging
  • Hospital mortality
  • Prognosis
  • Subdural hematoma
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{5d810c562c6c49c59c8c2bf2696eff5e,
title = "The Influence of Age on the Outcomes of Traumatic Brain Injury: Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)",
abstract = "Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8{\%} vs. 19.3{\%}; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.",
keywords = "Aging, Hospital mortality, Prognosis, Subdural hematoma, Traumatic brain injury",
author = "{J-ASPECT Study Collaborators} and Keitaro Yamagami and Ryota Kurogi and Ai Kurogi and Kunihiro Nishimura and Daisuke Onozuka and Nice Ren and Akiko Kada and Ataru Nishimura and Koichi Arimura and Keisuke Ido and Masahiro Mizoguchi and Tetsuya Sakamoto and Takamasa Kayama and Michiyasu Suzuki and Hajime Arai and Akihito Hagihara and Koji Iihara and Takigami Masayoshi and Kamiyama Kenji and Houkin Kiyohiro and Nishi Shougo and Yoshimoto Tetsuyuki and Kaneko Sadao and Oka Koji and Ooyama Hiroshi and Kamada Kyousuke and Makino Kenichi and Tokumitsu Naoki and Sako Kazuhiro and Suzuki Susumu and Suzuki Nozomi and Izumi Naoto and Nitta Kazumi and Ootaki Masahumi and Isobe Masanori and Nishiya Mikio and Yamazaki Takaaki and Mabuchi Syouji and Ogasawara Kuniaki and Kubo Naohiko and Shimizu Yukihiko and Saito Keiichi and Yamanome Tatumi and Yoshino Atsuo and Fujitsuka Mitsuyuki and Takami Masaaki and Ohtaka Hirotoshi and Hirano Teruyuki and Shiokawa Yosiaki and Kazunari Yoshida",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2019.05.140",
language = "English",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - The Influence of Age on the Outcomes of Traumatic Brain Injury

T2 - Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)

AU - J-ASPECT Study Collaborators

AU - Yamagami, Keitaro

AU - Kurogi, Ryota

AU - Kurogi, Ai

AU - Nishimura, Kunihiro

AU - Onozuka, Daisuke

AU - Ren, Nice

AU - Kada, Akiko

AU - Nishimura, Ataru

AU - Arimura, Koichi

AU - Ido, Keisuke

AU - Mizoguchi, Masahiro

AU - Sakamoto, Tetsuya

AU - Kayama, Takamasa

AU - Suzuki, Michiyasu

AU - Arai, Hajime

AU - Hagihara, Akihito

AU - Iihara, Koji

AU - Masayoshi, Takigami

AU - Kenji, Kamiyama

AU - Kiyohiro, Houkin

AU - Shougo, Nishi

AU - Tetsuyuki, Yoshimoto

AU - Sadao, Kaneko

AU - Koji, Oka

AU - Hiroshi, Ooyama

AU - Kyousuke, Kamada

AU - Kenichi, Makino

AU - Naoki, Tokumitsu

AU - Kazuhiro, Sako

AU - Susumu, Suzuki

AU - Nozomi, Suzuki

AU - Naoto, Izumi

AU - Kazumi, Nitta

AU - Masahumi, Ootaki

AU - Masanori, Isobe

AU - Mikio, Nishiya

AU - Takaaki, Yamazaki

AU - Syouji, Mabuchi

AU - Kuniaki, Ogasawara

AU - Naohiko, Kubo

AU - Yukihiko, Shimizu

AU - Keiichi, Saito

AU - Tatumi, Yamanome

AU - Atsuo, Yoshino

AU - Mitsuyuki, Fujitsuka

AU - Masaaki, Takami

AU - Hirotoshi, Ohtaka

AU - Teruyuki, Hirano

AU - Yosiaki, Shiokawa

AU - Yoshida, Kazunari

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

AB - Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

KW - Aging

KW - Hospital mortality

KW - Prognosis

KW - Subdural hematoma

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=85067351136&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067351136&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2019.05.140

DO - 10.1016/j.wneu.2019.05.140

M3 - Article

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -