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Risk factors for clinically important traumatic brain injury in minor head injury in older people - 28/05/24

Doi : 10.1016/j.ajem.2024.04.003 
Makoto Uchiyama, MD a, b, ⁎ , Kosuke Mori, MD a, Takeru Abe, PhD c , Shohei Imaki, MD a
a Department of Emergency Medicine, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama-shi, Kanagawa 221-0855, Japan 
b Department of Surgery, Shin-Kuki General Hospital, 418-1 Kamihayami, Kuki-shi, Saitama 346-8530, Japan 
c Center for Integrated Science and Humanities, Fukushima Medical University, 1 Hikariga-oka, Fukushima-shi, Fukushima 960-1295, Japan 

⁎Corresponding author at: Department of Surgery, Shin-Kuki General Hospital, 418-1 Kamihayami, Kuki-shi, Saitama 346-8530, Japan.Department of SurgeryShin-Kuki General Hospital418-1 KamihayamiKuki-shiSaitama346-8530Japan

Abstract

Background and objectives

The incidence of traumatic brain injury (TBI) in older individuals is increasing with an increase in the older population. For older people, the required medical interventions and hospitalization following minor head injury have negative impacts, which have not been reported in literature up till now. We aimed to investigate the risk factors for clinically important traumatic brain injury (ciTBI) in older patients with minor head injury.

Methods

This is a retrospective single-center cohort study. Older patients aged ≥65 years presenting with head injury and a Glasgow Coma Scale (GCS) score of ≥13 upon arrival at the hospital between January 1, 2018, and October 31, 2021, were included. Patients with an injury duration of ≥24 h were excluded. The primary outcome was defined as ciTBI (including death, surgery, intubation, medical interventions, and hospital stays of ≥2 nights). Multiple logistic regression analysis was conducted to identify the risk factors.

Results

A total of 296 patients were included initially, and 6 of them were excluded subsequently. ciTBI was identified in 62 cases. According to the results of the multiple logistic regression analysis, GCS scores of ≤14 (OR 3.72, 95% CI 1.89–7.30), high-risk mechanisms of injury (OR 2.80, 95% CI 1.39–5.64), vomiting (OR 5.01, 95% CI 1.19–21.1), and retrograde amnesia (OR 6.90, 95% CI 3.37–14.1) were identified as risk factors.

Conclusion

In older patients with minor head injury, GCS ≤14, high-risk mechanisms of injury, vomiting, and retrograde amnesia are risk factors for ciTBI.

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Keywords : Elderly, Minor head injury, ciTBI


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☆ This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
☆☆ The 36th Annual Meeting of the Japanese Association for the Surgery of Trauma, June 30, 2022.


© 2024  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 80

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