2007 Volume 30 Issue 2 Pages 120-126
Elderly patients (65 years of age or older) suffering traumatic brain injury (TBI) will increase as the population ages. It is found that many more elderly patients with severe TBI have admitted to our hospital in recent years. First, we studied age distribution, mechanisms of injury and outcome in 1025 inpatients after severe TBI during last 25 years. Second, of 318 hospitalized patients suffering mild to severe TBI in recent 2 years 86 cases with moderate or severe disability (MD or SD) were investigated whether or not to begin an early rehabilitation program after discharge from our hospital.
Severe TBI cases revealed a rapid decrease in number from 1980 to 1997 (group 1) followed by an increase from 1998 to 2004 (group 2). The elderly patients significantly increased between two groups (percentages of the elderly, 11% and 21%, respectively; p<0.001). The first and second most common mechanisms of injury in the elderly were traffic accidents (TAs, 58%) and falls (40%) in group 1. In group 2, TAs and falls were almost equal in occurrence (48% and 47%, respectively) and bicycle-related accidents became more frequent in the elderly. The outcome in the elderly at discharge was SD in 9.4%, a vegetative state (VS) in 10.6% and death in 76.5% in group 1, while SD in 27.6%, VS in 3.4% and death in 69.0% in group 2. The frequency of patients with SD was significantly higher in group 2 than in group 1.
Of 86 patients 40 developed MD and 46 became SD. There were more patients with SD in the elderly than in the nonelderly (75%and 49%, respectively). Most elderly individuals transferred to a community hospital (absent department of Neurosurgery) but not to a rehabilitation institute, so they could not participate in an early rehabilitation program.
