Brain Injuries Clinical Trial
Official title:
Risk Factors Predicting Prognosis and Outcome of Elderly Patients With Isolated Traumatic Brain Injury
Although several prognostic models have been developed to predict outcome for patients with
severe traumatic brain injury (TBI), currently no study describes the impact of respiratory
failure during Emergency Department treatment on mortality in a population of elderly
patients. The purpose of the present study was to evaluate factors predicting poor outcome
with special emphasis on the impact of respiratory failure on mortality in elderly patients
with isolated severe TBI.
All elderly patients (age ≥ 65 years) with isolated severe head injury, admitted to this
Level I trauma center, during a period of 16 years (from January 1992 to December 2008) were
identified from the trauma registry. Stepwise logistic regression analysis was used to
identify risk factors for a poor prognosis and outcome.
The logistic regression found the following variables influencing the mortality: respiratory
failure (p<0.0005; OR: 9.369), pupillary response (p<0.0212, OR: 3.393) and ISS score
(p<0.0001, OR:1.179). A significant (p<0.0001) increased risk of death was also found for
patients with a midline shift >15 mm.
The present study predicts a strong correlation between respiratory failure, pathological
pupillary response, a higher ISS and substantial midline shift with poor outcomes in elderly
patients sustaining an isolated severe TBI.
n/a
Time Perspective: Retrospective
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