- Among elderly adults with traumatic brain injury (TBI), 6-month mortality is high.
- Authors: “routine trauma center transport in this patient population may not be necessary.”
Why this matters
- Elderly people are more vulnerable to TBI.
- Median age, 70 years.
- Most common mechanism: fall from standing height or higher.
- 73% were transferred to a Level 1 or 2 trauma center.
- At 6-month follow-up:
- 46% (119/260) had at least moderate disability.
- 21% (55/260) had died.
- 55% of those deaths were because of illness or non-head injury.
- Worse 6-month Extended Glasgow Outcome Scale (GOS-E) scores correlated with:
- Abnormal Glasgow Coma Scale score.
- More comorbidities.
- Traumatic intracranial hemorrhage on initial emergent imaging.
- Transport to trauma center was not associated with 6-month GOS-E scores in either the general study population or a subset with traumatic intracranial hemorrhage.
- Prospective observational study, California, comprising 5 single-county emergency medical services (EMS) agencies and 11 hospitals.
- Participants were adults ≥55 years with TBI transported to a hospital by EMS (n=350).
- Outcomes: Function at 3 and 6 months per GOS-E, via telephone follow-up.
- Funding: CDC.
- 25% lost to follow-up.
- Few required neurosurgery, limiting ability to estimate benefit of transfer in that subgroup.