Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted

The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based pred...

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Main Authors: Cecilie Røe, Toril Skandsen, Unn Manskow, Tiina Ader, Audny Anke
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Behavioural Neurology
Online Access:http://dx.doi.org/10.1155/2015/845491
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author Cecilie Røe
Toril Skandsen
Unn Manskow
Tiina Ader
Audny Anke
author_facet Cecilie Røe
Toril Skandsen
Unn Manskow
Tiina Ader
Audny Anke
author_sort Cecilie Røe
collection DOAJ
description The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI.
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spelling doaj-art-e25a684f808149c3954994582e044f782025-08-20T02:21:13ZengWileyBehavioural Neurology0953-41801875-85842015-01-01201510.1155/2015/845491845491Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and PredictedCecilie Røe0Toril Skandsen1Unn Manskow2Tiina Ader3Audny Anke4Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, NorwayDepartment of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayFaculty of Health Sciences, Institute of Clinical Medicine, University of Tromso, NorwayDepartment of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, NorwayFaculty of Health Sciences, Institute of Clinical Medicine, University of Tromso, NorwayThe aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI.http://dx.doi.org/10.1155/2015/845491
spellingShingle Cecilie Røe
Toril Skandsen
Unn Manskow
Tiina Ader
Audny Anke
Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
Behavioural Neurology
title Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
title_full Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
title_fullStr Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
title_full_unstemmed Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
title_short Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted
title_sort mortality and one year functional outcome in elderly and very old patients with severe traumatic brain injuries observed and predicted
url http://dx.doi.org/10.1155/2015/845491
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