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

CENTER-TBI Participants and Investigators; Marjolein van der Vlegel; Ana Mikolić; Quentin Lee Hee; Z.L. Rana Kaplan; Isabel R.A. Retel Helmrich; Ernest van Veen; Nada Andelic; Nicole V Steinbuechel; Anne Marie Plass; Marina Zeldovich; Lindsay Wilson; Andrew I.R. Maas; Juanita A Haagsma; Suzanne Polinder

doi:10.1016/j.injury.2022.05.009

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

CENTER-TBI Participants and Investigators
, Marjolein van der Vlegel^*
, Ana Mikolić
, Quentin Lee Hee
, Z.L. Rana Kaplan
, Isabel R.A. Retel Helmrich
, Ernest van Veen
, Nada Andelic
, Nicole V Steinbuechel
, Anne Marie Plass
, Marina Zeldovich
, Lindsay Wilson
, Andrew I.R. Maas
, Juanita A Haagsma
, Suzanne Polinder

^*Corresponding author for this work

Inflammation and Ageing

Research output: Contribution to journal › Article › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	2774-2782
Number of pages	9
Journal	Injury
Volume	53
Issue number	8
Early online date	26 May 2022
DOIs	https://doi.org/10.1016/j.injury.2022.05.009
Publication status	Published - Aug 2022

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Aged
Brain Injuries, Traumatic
Glasgow Outcome Scale
Humans
Patient Acceptance of Health Care
Prospective Studies
Quality of Life/psychology

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CENTER-TBI Participants and Investigators, van der Vlegel, M., Mikolić, A., Lee Hee, Q., Kaplan, Z. L. R., Retel Helmrich, I. R. A., van Veen, E., Andelic, N., Steinbuechel, N. V., Plass, A. M., Zeldovich, M., Wilson, L., Maas, A. I. R., Haagsma, J. A., & Polinder, S. (2022). Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study. Injury, 53(8), 2774-2782. https://doi.org/10.1016/j.injury.2022.05.009

@article{ec761691c4f94839a02eb18366450d66,

title = "Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study",

abstract = "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.",

keywords = "Aged, Brain Injuries, Traumatic, Glasgow Outcome Scale, Humans, Patient Acceptance of Health Care, Prospective Studies, Quality of Life/psychology",

author = "\{CENTER-TBI Participants and Investigators\} and \{van der Vlegel\}, Marjolein and Ana Mikoli{\'c} and \{Lee Hee\}, Quentin and Kaplan, \{Z.L. Rana\} and \{Retel Helmrich\}, \{Isabel R.A.\} and \{van Veen\}, Ernest and Nada Andelic and Steinbuechel, \{Nicole V\} and Plass, \{Anne Marie\} and Marina Zeldovich and Lindsay Wilson and Maas, \{Andrew I.R.\} and Haagsma, \{Juanita A\} and Suzanne Polinder and Antonio Belli",

note = "Copyright {\textcopyright} 2022. Published by Elsevier Ltd.",

year = "2022",

month = aug,

doi = "10.1016/j.injury.2022.05.009",

language = "English",

volume = "53",

pages = "2774--2782",

journal = "Injury",

issn = "0020-1383",

publisher = "Elsevier",

number = "8",

}

CENTER-TBI Participants and Investigators, van der Vlegel, M, Mikolić, A, Lee Hee, Q, Kaplan, ZLR, Retel Helmrich, IRA, van Veen, E, Andelic, N, Steinbuechel, NV, Plass, AM, Zeldovich, M, Wilson, L, Maas, AIR, Haagsma, JA & Polinder, S 2022, 'Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study', Injury, vol. 53, no. 8, pp. 2774-2782. https://doi.org/10.1016/j.injury.2022.05.009

TY - JOUR

T1 - Health care utilization and outcomes in older adults after Traumatic Brain Injury

T2 - A CENTER-TBI study

AU - CENTER-TBI Participants and Investigators

AU - van der Vlegel, Marjolein

AU - Mikolić, Ana

AU - Lee Hee, Quentin

AU - Kaplan, Z.L. Rana

AU - Retel Helmrich, Isabel R.A.

AU - van Veen, Ernest

AU - Andelic, Nada

AU - Steinbuechel, Nicole V

AU - Plass, Anne Marie

AU - Zeldovich, Marina

AU - Wilson, Lindsay

AU - Maas, Andrew I.R.

AU - Haagsma, Juanita A

AU - Polinder, Suzanne

AU - Belli, Antonio

PY - 2022/8

Y1 - 2022/8

N2 - 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.

AB - 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.

KW - Aged

KW - Brain Injuries, Traumatic

KW - Glasgow Outcome Scale

KW - Humans

KW - Patient Acceptance of Health Care

KW - Prospective Studies

KW - Quality of Life/psychology

U2 - 10.1016/j.injury.2022.05.009

DO - 10.1016/j.injury.2022.05.009

M3 - Article

C2 - 35725508

SN - 0020-1383

VL - 53

SP - 2774

EP - 2782

JO - Injury

JF - Injury

IS - 8

ER -

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

Abstract

Bibliographical note

UN SDGs

Keywords

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