Risk factors for intracranial lesions and mortality in older patients with mild traumatic brain injuries

ABSTRACT

Primary Objective: To identify risk factors for intracerebral lesion (ICL) in older adults with mild traumatic brain injury (MTBI) and evaluate the influence of comorbidities on outcomes.

Research Design: Prospective cohort study.

Methods and Procedures: Information was gathered on clinical history/examination, cranial computed tomography, admission Glasgow Coma Scale (GCS) score, analytical and coagulation findings, and mortality at 1 week post-discharge. Bivariate and multivariate logistic regression analyses were performed, calculating odds ratios for ICL with 95% confidence interval. P < 0.05 was considered significant.

Main Outcomes and Results: Data were analyzed on 504 patients with mean±SD age of 79.37 ± 8.06 years. Multivariate analysis showed that traffic accident, GCS score of 14/15, transient consciousness loss, nausea, and receipt of antiplatelets were predictors of ICL, while SRRI and/or benzodiazepine intake was a protective factor. A score was assigned to patients by rounding OR values, and a score ≥1 indicated moderate/high risk of ICL.

Conclusions: MTBI management should be distinct in over-60 year-olds, who may not present typical symptoms, with frequent comorbidities. Knowledge of risk factors for post-MTBI ICL, associated with higher mortality, is important to support clinical decision-making. Further research is warranted to verify our novel finding that benzodiazepines and/or SSRI inhibitors may act as neuroprotectors.

KEYWORDS:

• Score- Traumatic brain injury
• over 60 years
• neuroprotectors

Acknowledgments

The authors are grateful to Manuela Expósito of the FIBAO Foundation (Granada) for help with the statistical analysis and to Richard Davies for editorial assistance.

Disclosure statement

No potential conflict of interest was reported by the authors.