Changing Demographic Profiles of Patients With Traumatic Brain Injury: An Aging Concern

Abstract

Background: Trauma continues to be a common cause of mortality in Singapore. By understanding the epidemiology of Traumatic Brain Injury (TBI), healthcare professionals can be better equipped to tackle the increasing socioeconomic burden of disease, adopting better strategies in healthcare planning. Methodology: A retrospective review of 367 patients admitted with TBI to a tertiary medical institution from January to December 2014 was performed, studying demographic profiles, injury details and outcomes of these patients. Data was retrieved from the National Trauma Registry and the institution's database. Results: Two hundred thirty-four of the 367 patients included in this study fell into two age groups-−19 to 40 years and ≥65 years. 58% of the TBI population were aged >60. Predominant mechanism of injuries in these groups were road traffic accidents and unwitnessed falls respectively. 39% of the Elderly group were on antiplatelet/anticoagulant agents ( p < 0.001). While aggressive surgical intervention was more common in younger patients ( p < 0.001), the elderly group had significantly longer lengths of hospital stay ( p < 0.001). Though Glasgow Outcome Scale (GOS) scores at discharge were not significantly different between the two groups, elderly patients showed greater percentages of post-injury improvement subsequently. Conclusion: The demographics of TBI patients appears to have shifted toward an older population as compared to a decade ago, with an increased incidence of falls, highlighting a huge healthcare concern. We hope that this study will drive further nationwide studies in future, looking at the incidence and prevalence of TBI, and with the focus on tackling preventable causes of TBI.

Mortality in polytrauma patients with moderate to severe TBI on par with isolated TBI patients: TBI as last frontier in polytrauma patients

“…Over the three-year study period, 259 eligible patients were admitted to ICU with 111 P TBI patients and 148 I TBI patients. Most patients were male (68%), suffered from blunt force trauma (98%), with a median age of 54 [33-67] years, a median ISS of 26 [20][21][22][23][24][25][26][27][28][29][30][31][32][33], and a median AIS head of 4 [4][5]. Further demographics and AIS scores are displayed in Table 1.…”

“…Patient demographics, shock and resuscitation parameters, multiple organ dysfunction syndrome (MODS), acute respiratory distress syndrome (ARDS), and mortality data were collected and analyzed for group differences.Results: 259 patients were included; 111 P TBI and 148 I TBI patients. The median age was 54 years, 177 (68%) patients were male, median ISS was 26 [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Seventy-nine (31%) patients died.…”

“…Results: 259 patients were included; 111 P TBI and 148 I TBI patients. The median age was 54 years, 177 (68%) patients were male, median ISS was 26 [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Seventy-nine (31%) patients died.…”

Demographics of traumatic brain injury and outcomes of continuous chain of early rehabilitation in Singapore

“…This was also the case in a recent study which reported a shift in local TBI demographics towards an older population, with an increased incidence of falls. 27 The rates of fall-related TBI could increase due to our rapidly ageing nation, which highlights the need to identify at-risk elderly populations and strengthen fall-prevention strategies.…”

Severe traumatic brain injury (TBI) – a seven-year comparative study in a Department of Forensic Medicine

“…GCS is an instrument of neurological evaluation intensely used in classifying brain lesions, especially in the acute stage of the lesions: the lower the GCS score, the more intense the brain lesions are [55]. Still, the patients over 65 years old had a poorer progress, regardless of the nature of the traumatic injury or GCS score at hospital admission, due to the cerebral changes related to age and some comorbidities [56,57]. Due to these reasons, numerous studies considered that old age represents an important risk factor in TBIs [58][59][60][61].…”