Research Reports - Mortality among older adults after a traumatic brain injury: A meta-analysis

Brain Inj. 2012 Nov 19

McIntyre A, Mehta S, Aubut J, Dijkers M, Teasell RW

Primary objective: To examine mortality rates among older adults (≥60 years)
post-traumatic brain injury (TBI). Research design: Systematic review and
meta-analysis. Methods and procedures: Using multiple databases, a literature
search was conducted for articles on mortality after TBI published up to July
2011. Information on patient characteristics (age, Glasgow Coma Scale (GCS),
injury aetiology, etc.), mortality rates, time to death and study design was
extracted and pooled. Main outcomes and results: Twenty-four studies had an
overall mortality rate of 38.3% (CI 27.1-50.9%). The odds of mortality for those
over 75 years compared to those of 65-74 years was 1.734 (CI = 1.311-2.292;
p < 0.0001). Pooled mortality rates for mild (GCS 13-15), moderate (GCS 9-12) and
severe (GCS 3-8) head injuries were 12.3% (CI = 6.1-23.3%), 34.3%
(CI = 19.5-53.0%) and 65.3% (CI = 53.1-75.9), respectively. Odds ratios comparing
severe to mild and moderate to mild head injuries were 12.69 (CI = 5.29-30.45;
p < 0.0001) and 5.31 (CI = 3.41-8.29; p < 0.0001), respectively. There was no
significant difference in the odds of death between severe and moderate injuries
(p = 0.116). Conclusions: These mortality rates associated with moderate and
severe injuries may be attributed to complications, chronic disease prevalence,
conservative management techniques or the consequences of biological ageing.

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