Traumatic brain injury in the elderly after a skiing accident: A retrospective cohort study in a level 1 emergency department in Switzerland.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2022
Historique:
received: 01 05 2022
accepted: 03 08 2022
entrez: 17 8 2022
pubmed: 18 8 2022
medline: 20 8 2022
Statut: epublish

Résumé

Skiing is a very popular sport worldwide, with increasing trends over the past decades. This study aimed to evaluate the importance of traumatic brain injury (TBI), especially in the elderly, after a ski accident, and to describe its short-term repercussions. Patients were analyzed who were admitted to our neurotrauma center from 2012-2018 after a head trauma while skiing. Three different age groups were differentiated and analyzed for the severity of TBI depending on the initial Glasgow Coma Scale as the primary outcome and as secondary outcomes need and type of surgery, Glasgow Outcome Score, preexisting use of anticoagulant or antiplatelet drugs, time to presentation, and pattern of brain injury. TBI severity was adjusted to the time to initial medical consultation. No significant difference in TBI severity was found when comparing the middle (>29-54) and older (≥54) age groups to the reference group <30 years (OR:0.45, p = 0.127; OR:0.46, p = 0.17). Acute subdural hemorrhage was present in 21.2% of the ≥55 group and 14.5% of the 30-54 age group, compared to 12.8% of the youngest group (p = <0.001). Overall, 39.4% of the patients in the ≥55 group and 8.1% of the 30-54 age group presented with chronic subdural hemorrhage, whereas none of the youngest patients did (p = <0.001). No differences were observed in terms of TBI severity between age groups after acute trauma. Nonetheless, a different pattern of head injury after TBI in older patients was demonstrated. Accordingly, the management differs for these TBIs compared to those of younger patients.

Sections du résumé

BACKGROUND
Skiing is a very popular sport worldwide, with increasing trends over the past decades. This study aimed to evaluate the importance of traumatic brain injury (TBI), especially in the elderly, after a ski accident, and to describe its short-term repercussions.
METHODOLOGY
Patients were analyzed who were admitted to our neurotrauma center from 2012-2018 after a head trauma while skiing. Three different age groups were differentiated and analyzed for the severity of TBI depending on the initial Glasgow Coma Scale as the primary outcome and as secondary outcomes need and type of surgery, Glasgow Outcome Score, preexisting use of anticoagulant or antiplatelet drugs, time to presentation, and pattern of brain injury. TBI severity was adjusted to the time to initial medical consultation.
RESULTS
No significant difference in TBI severity was found when comparing the middle (>29-54) and older (≥54) age groups to the reference group <30 years (OR:0.45, p = 0.127; OR:0.46, p = 0.17). Acute subdural hemorrhage was present in 21.2% of the ≥55 group and 14.5% of the 30-54 age group, compared to 12.8% of the youngest group (p = <0.001). Overall, 39.4% of the patients in the ≥55 group and 8.1% of the 30-54 age group presented with chronic subdural hemorrhage, whereas none of the youngest patients did (p = <0.001).
CONCLUSION
No differences were observed in terms of TBI severity between age groups after acute trauma. Nonetheless, a different pattern of head injury after TBI in older patients was demonstrated. Accordingly, the management differs for these TBIs compared to those of younger patients.

Identifiants

pubmed: 35976893
doi: 10.1371/journal.pone.0273168
pii: PONE-D-22-12754
pmc: PMC9384986
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0273168

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Alberto Consuegra (A)

Department of Neurosurgery, University of Bern, Bern University Hospital, Bern, Switzerland.

Katharina Lutz (K)

Department of Neurosurgery, University of Bern, Bern University Hospital, Bern, Switzerland.

Aristomenis K Exadaktylos (AK)

Department of Emergency Medicine, University of Bern, Bern University Hospital, Bern, Switzerland.

Werner J Z'Graggen (WJ)

Department of Neurosurgery, University of Bern, Bern University Hospital, Bern, Switzerland.

Rebecca M Hasler (RM)

Department of Emergency Medicine, University of Bern, Bern University Hospital, Bern, Switzerland.

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Classifications MeSH