| Clinical Features of Geriatric Moderate and Severe Head Injury |
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Woo-Yong Lee , Oh-Lyong Kim, Byung-Yun Choi , Seong-Ho Kim |
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Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea |
| 노인 중등도 및 중증 두부외상의 임상 양상 |
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| Abstract |
Objective
Geriatric trauma patients have a worse outcome than the young with comparable injuries. Despite an
increasing incidence, relatively few studies have examined the geriatric traumatic brain injuries (TBI). The purpose
of this study was to investigate the prognosis of an elderly trauma patients with moderate and severe head injury
and to find out the factors related to moderate and severe head injury.
Methods
A clinical analysis was carried out retrospectively with 88 cases of moderate to severe head injured
patients (Glasgow coma scale score 3~13), aged 65 and older admitted at our institution for 5 years from July
2000 to June 2005, based on the medical reports and radiological results.
Results
The proportion of geriatric moderate head injury and severe head injury were 46 patients (10.6%) and
42 patients (9.6%). Mean age of the studied patients was 71.0 years of age and the ratio of male to female was
2.0:1. The incidence of pre-existing disease, such as hypertension (53.1%), diabetes mellitus (23.0%) was high. The
main causes of the injuries were slip down (36.3%) and pedestrian traffic accident (15.9%). Alcohol was a contributory
factor in thirteen patients (14.8%). The single most common lesion was intracerebral hematoma (39.8%). During admission,
medical complication such as pneumonia (27.3%), subdural hygroma (14.8%), cardiac problem (10.2%) were common,
Twenty-five of eighty-eight patients (28.4%) died and non-cerebral main causes of death was pneumonia and acute
respiratory distress syndrome (8.0%).
Conclusion
Our findings indicate that pedestrian and motorcycle traffic accident show more severity in geriatric
head injury patients, and alcohol was a contributory factor. Pneumonia and acute respiratory distress syndrome
are major contributors to morbidity and mortality in trauma patients. It is therefore the factors of intracranial and
extracranial causes which influence the survival and outcome be carefully considered and treated. Earlier identification
of risk and aggressive supports may be needed for decreasing the morbidity and the mortality in the elderly. |
| Key Words:
Traumatic brain injuriesㆍGeriatrics |
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