Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study.

van der Vlegel, Marjolein; Mikolić, Ana; Lee Hee, Quentin; Kaplan, Z L Rana; Retel Helmrich, Isabel R A; van Veen, Ernest; Andelic, Nada; Steinbuechel, Nicole V; Plass, Anne Marie; Zeldovich, Marina; Wilson, Lindsay; Maas, Andrew I R; Haagsma, Juanita A; Polinder, Suzanne; Åkerlund, Cecilia; George, Pradeep; Lanyon, Linda; Muraleedharan, Visakh; Nelson, David; Amrein, Krisztina; Ezer, Erzsébet; Kovács, Noémi; Melegh, Béla; Nyirádi, József; Tamás, Viktória; Vámos, Zoltán; Sorinola, Abayomi; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Antoni, Anna; Schwendenwein, Elisabeth; Audibert, Gérard; Azouvi, Philippe; Azzolini, Maria Luisa; Beretta, Luigi; Calvi, Maria Rosa; Bartels, Ronald; Boogert, Hugo den; Barzó, Pál; Beauvais, Romuald; Perera, Natascha; Beer, Ronny; Helbok, Raimund; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Degos, Vincent; Galanaud, Damien; Perlbarg, Vincent; Berardino, Maurizio; Cavallo, Simona; Blaabjerg, Morten; Rosenlund, Christina; Schou, Rico Frederik; Bragge, Peter; Brazinova, Alexandra; Majdan, Marek; Taylor, Mark Steven; Zelinkova, Veronika; Brinck, Vibeke; Jarrett, Mike; Brooker, Joanne; Donoghue, Emma; Synnot, Anneliese; Brorsson, Camilla; Koskinen, Lars-Owe; Sundström, Nina; Buki, Andras; Czeiter, Endre; Bullinger, Monika; Cabeleira, Manuel; Czosnyka, Marek; Dixit, Abhishek; Ercole, Ari; Koraropoulos, Evgenios; Menon, David; Newcombe, Virginia; Richter, Sophie; Smielewski, Peter; Stamatakis, Emmanuel; Williams, Guy; Winzeck, Stefan; Zeiler, Frederick A; Caccioppola, Alessio; Calappi, Emiliana; Carbonara, Marco; Ortolano, Fabrizio; Zoerle, Tommaso; Stocchetti, Nino; Cameron, Peter; Gantner, Dashiell; Murray, Lynnette; Trapani, Tony; Vallance, Shirley; Lozano, Guillermo Carbayo; Pomposo, Inigo; Castaño-León, Ana M; Gomez, Pedro A; Lagares, Alfonso; Chevallard, Giorgio; Chieregato, Arturo; Citerio, Giuseppe; Vargiolu, Alessia; Ceyisakar, Iris; Gravesteijn, Benjamin; Haagsma, Juanita A; Huijben, Jilske; Lingsma, Hester; Nieboer, Daan; Mikolic, Ana; Polinder, Suzanne; Sewalt, Charlie; Steyerberg, Ewout W; Velt, Kimberley; Voormolen, Daphne; Wiegers, Eveline; Peul, Wilco; van Dijck, Jeroen T J M; van Essen, Thomas A; van Wijk, Roel P J; Clusmann, Hans; Coburn, Mark; Kowark, Ana; Rossaint, Rolf; Coles, Jonathan; Cooper, Jamie D; Correia, Marta; Čovid, Amra; von Steinbüchel, Nicole; Curry, Nicola; Stanworth, Simon; Dahyot-Fizelier, Claire; Dark, Paul; Johnson, Faye; Dawes, Helen; Esser, Patrick; van Heugten, Caroline; De Keyser, Véronique; Maas, Andrew I R; Menovsky, Tomas; Van der Steen, Gregory; Corte, Francesco Della; Grossi, Francesca; Depreitere, Bart; Đilvesi, Đula; Golubovic, Jagoš; Karan, Mladen; Vulekovic, Petar; Dreier, Jens; Vajkoczy, Peter; Wolf, Stefan; Dulière, Guy-Loup; Maréchal, Hugues; Fabricius, Martin; Kondziella, Daniel; Feigin, Valery L; Jones, Kelly; Ao, Braden Te; Theadom, Alice; Foks, Kelly; Haitsma, Iain; Volovici, Victor; Furmanov, Alex; Rosenthal, Guy; Gagliardo, Pablo; Gao, Guoyi; Jiang, Ji-yao; Ghuysen, Alexandre; Giga, Lelde; Valeinis, Egils; Ziverte, Agate; Glocker, Ben; Rueckert, Daniel; Gratz, Johannes; Gruen, Russell L; Gupta, Deepak; Roe, Cecilie; Helseth, Eirik; Roise, Olav; Horton, Lindsay; Wilson, Lindsay; Hutchinson, Peter J; Kolias, Angelos G; Jacobs, Bram; van der Naalt, Joukje; Jankowski, Stefan; Kompanje, Erwin; Timmers, Marjolein; Laureys, Steven; Ledoux, Didier; Misset, Benoit; Lecky, Fiona; Olubukola, Otesile; Lefering, Rolf; Schäfer, Nadine; Legrand, Valerie; Lejeune, Aurelie; Vega, Emmanuel; Mattern, Julia; Levi, Leon; Lightfoot, Roger; Maegele, Marc; Manara, Alex; Thomas, Matt; Manley, Geoffrey; Martino, Costanza; Sakowitz, Oliver; Sanchez-Porras, Renan; Younsi, Alexander; McMahon, Catherine; Negru, Ancuta; Oresic, Matej; Palotie, Aarno; Parizel, Paul M; Payen, Jean-François; Persona, Paolo; Piippo-Karjalainen, Anna; Pirinen, Matti; Ples, Horia; Posti, Jussi P; Puybasset, Louis; Radoi, Andreea; Ragauskas, Arminas; Raj, Rahul; Rambadagalla, Malinka; Rhodes, Jonathan; Richardson, Sylvia; Ripatti, Samuli; Rocka, Saulius; Rosand, Jonathan; Rosenfeld, Jeffrey V; Rossi, Sandra; Rusnák, Martin; Sahuquillo, Juan; Sandor, Janos; Schmidt, Silke; Schoechl, Herbert; Schoonman, Guus; Skandsen, Toril; Stevens, Robert; Stewart, William; Takala, Riikka; Tamosuitis, Tomas; Tenovuo, Olli; Tibboel, Dick; Tolias, Christos; Tudora, Cristina Maria; van der Jagt, Mathieu; Van Hecke, Wim; Van Praag, Dominique; Vyvere, Thijs Vande; Verheyden, Jan; Vespa, Paul M; Vik, Anne; Vilcinis, Rimantas; Wang, Kevin K W; Yang, Zhihui; Ylén, Peter     «

van der Vlegel, Marjolein; Mikolić, Ana; Lee Hee, Quentin; Kaplan, Z L Rana; Retel Helmrich, Isabel R A; van Veen, Ernest; Andelic, Nada; Steinbuechel, Nicole V; Plass, Anne Marie; Zeldovich, Marina; Wilson, Lindsay; Maas, Andrew I R; Haagsma, Juanita A; Polinder, Suzanne; Åkerlund, Cecilia; George, Pradeep; Lanyon, Linda; Muraleedharan, Visakh; Nelson, David; Amrein, Krisztina; Ezer, Erzsébet; Kovács, Noémi; Melegh, Béla; Nyirádi, József; Tamás, Viktória; Vámos, Zoltán; Sorinola, Abayomi; Andel...     »

INTRODUCTION: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. METHODS: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. RESULTS: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. CONCLUSION: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.      «

INTRODUCTION: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. METHODS: We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in...     »