The Influence of Age on the Outcomes of Traumatic Brain Injury: Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)

J-ASPECT Study Collaborators

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

Original languageEnglish
Pages (from-to)e26-e46
JournalWorld Neurosurgery
Volume130
DOIs
Publication statusPublished - 10-2019

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Hospital Mortality
Odds Ratio
Traumatic Brain Injury
Surveys and Questionnaires
Length of Stay
Brain Concussion
Hematoma, Subdural, Acute
Sex Ratio
Coma
Consciousness
Nervous System
Japan
Epidemiology
Demography
Databases
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

@article{2226b6f861014e0299d9d4de0f824c52,
title = "The Influence of Age on the Outcomes of Traumatic Brain Injury: Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)",
abstract = "Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8{\%} vs. 19.3{\%}; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.",
author = "{J-ASPECT Study Collaborators} and Keitaro Yamagami and Ryota Kurogi and Ai Kurogi and Kunihiro Nishimura and Daisuke Onozuka and Nice Ren and Akiko Kada and Ataru Nishimura and Koichi Arimura and Keisuke Ido and Masahiro Mizoguchi and Tetsuya Sakamoto and Takamasa Kayama and Michiyasu Suzuki and Hajime Arai and Akihito Hagihara and Koji Iihara and Masayoshi Takigami and Kenji Kamiyama and Kiyohiro Houkin and Shougo Nishi and Tetsuyuki Yoshimoto and Sadao Kaneko and Koji Oka and Hiroshi Ooyama and Kyousuke Kamada and Kenichi Makino and Naoki Tokumitsu and Kazuhiro Sako and Susumu Suzuki and Nozomi Suzuki and Naoto Izumi and Kazumi Nitta and Masahumi Ootaki and Masanori Isobe and Mikio Nishiya and Takaaki Yamazaki and Syouji Mabuchi and Kuniaki Ogasawara and Naohiko Kubo and Yukihiko Shimizu and Keiichi Saito and Tatumi Yamanome and Atsuo Yoshino and Mitsuyuki Fujitsuka and Masaaki Takami and Hirotoshi Ohtaka and Teruyuki Hirano and Yosiaki Shiokawa and Takaharu Okada",
year = "2019",
month = "10",
doi = "10.1016/j.wneu.2019.05.140",
language = "English",
volume = "130",
pages = "e26--e46",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

The Influence of Age on the Outcomes of Traumatic Brain Injury : Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury). / J-ASPECT Study Collaborators.

In: World Neurosurgery, Vol. 130, 10.2019, p. e26-e46.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Influence of Age on the Outcomes of Traumatic Brain Injury

T2 - Findings from a Japanese Nationwide Survey (J-ASPECT Study-Traumatic Brain Injury)

AU - J-ASPECT Study Collaborators

AU - Yamagami, Keitaro

AU - Kurogi, Ryota

AU - Kurogi, Ai

AU - Nishimura, Kunihiro

AU - Onozuka, Daisuke

AU - Ren, Nice

AU - Kada, Akiko

AU - Nishimura, Ataru

AU - Arimura, Koichi

AU - Ido, Keisuke

AU - Mizoguchi, Masahiro

AU - Sakamoto, Tetsuya

AU - Kayama, Takamasa

AU - Suzuki, Michiyasu

AU - Arai, Hajime

AU - Hagihara, Akihito

AU - Iihara, Koji

AU - Takigami, Masayoshi

AU - Kamiyama, Kenji

AU - Houkin, Kiyohiro

AU - Nishi, Shougo

AU - Yoshimoto, Tetsuyuki

AU - Kaneko, Sadao

AU - Oka, Koji

AU - Ooyama, Hiroshi

AU - Kamada, Kyousuke

AU - Makino, Kenichi

AU - Tokumitsu, Naoki

AU - Sako, Kazuhiro

AU - Suzuki, Susumu

AU - Suzuki, Nozomi

AU - Izumi, Naoto

AU - Nitta, Kazumi

AU - Ootaki, Masahumi

AU - Isobe, Masanori

AU - Nishiya, Mikio

AU - Yamazaki, Takaaki

AU - Mabuchi, Syouji

AU - Ogasawara, Kuniaki

AU - Kubo, Naohiko

AU - Shimizu, Yukihiko

AU - Saito, Keiichi

AU - Yamanome, Tatumi

AU - Yoshino, Atsuo

AU - Fujitsuka, Mitsuyuki

AU - Takami, Masaaki

AU - Ohtaka, Hirotoshi

AU - Hirano, Teruyuki

AU - Shiokawa, Yosiaki

AU - Okada, Takaharu

PY - 2019/10

Y1 - 2019/10

N2 - Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

AB - Background: The epidemiology of patients with traumatic brain injury (TBI) has changed dramatically over recent decades as a result of rapid advances in aging societies. We assessed the influence of age on outcomes of patients with TBI and sought to identify prognostic factors for in-hospital mortality of TBI among elderly patients. Methods: Using a nationwide database, we analyzed data from 5651 patients with TBI. Univariate analysis was conducted to compare patient demographics, neurologic status on admission, radiologic findings, systemic complication rates, length of hospital stay, in-hospital mortality, and home discharge rates between elderly and nonelderly groups. Multivariable analysis was conducted to determine prognostic factors for in-hospital mortality among elderly patients. Results: Overall in-hospital mortality was significantly higher in elderly patients (12.8% vs. 19.3%; P < 0.001). In-hospital mortality of elderly patients with mild TBI increased significantly at >7 days after admission, whereas that of elderly patients with moderate or severe TBI was significantly higher immediately after admission. Age (odds ratio [OR], 1.62; P = 0.024), male sex (OR, 1.30; P = 0.004), Japan Coma Scale score on admission (OR, 5.95, P < 0.001), and incidence of acute subdural hematoma (OR, 1.89; P < 0.001) were associated with in-hospital mortality in elderly patients with TBI. Conclusions: Elderly patients with TBI showed significantly higher in-hospital mortality. Delayed increases in in-hospital mortality were observed among elderly patients with mild TBI. Level of consciousness on admission was the strongest predictor of in-hospital mortality among elderly patients.

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U2 - 10.1016/j.wneu.2019.05.140

DO - 10.1016/j.wneu.2019.05.140

M3 - Article

C2 - 31132488

AN - SCOPUS:85067351136

VL - 130

SP - e26-e46

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -