Comparative Study of Surgical Outcome and the Features on Old versus Young Aged Traumatic Brain Injury Patients

Min-Hyuk Lee; Yoon-Soo Lee; Jeong-Ho Lee; Kee-Young Ryu; Dong Gee Kang

doi:10.13004/jknts.2010.6.2.125

Journal List > J Korean Neurotraumatol Soc > v.6(2) > 1084064

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Lee, Lee, Lee, Ryu, and Kang: Comparative Study of Surgical Outcome and the Features on Old versus Young Aged Traumatic Brain Injury Patients

Clinical Article

Journal of Korean Neurotraumatology Society 2010; 6(2): 125-131.

Published online: 31 December 2010

DOI: https://doi.org/10.13004/jknts.2010.6.2.125

Comparative Study of Surgical Outcome and the Features on Old versus Young Aged Traumatic Brain Injury Patients

Min-Hyuk Lee, MD, Yoon-Soo Lee, MD, Jeong-Ho Lee, MD, Kee-Young Ryu, MD, Dong Gee Kang, MD

Department of Neurosurgery, Daegu Fatima Hospital, Daegu, Korea.

Address for correspondence: Min-Hyuk Lee, MD. Department of Neurosurgery, Daegu Fatima Hospital, 576-31 Sinam-dong, Dong-gu, Daegu 701-600, Korea. Tel: +82-53-940-7330, 7339, Fax: +82-53-954-7417, myiki@msn.com

Received 24 August 2010 Revised 30 August 2010 Accepted 24 September 2010

Abstract

Objective

The purpose of this study is to evaluate features, prognostic factors and outcome of old aged traumatic brain injury to old patients compared with young patients.

Methods

172 patients with surgically treated traumatic brain injury between January 2004 and December 2009 were reviewed. The patients divided into two groups according to their ages. One (Group A) consisted of 75 patients aged 60 years or more, and the other (Group B) consisted of 97 patients aged under 60 years. We analyzed clinical status, mortality and outcome.

Results

The mean age of all patients was 50.73 years old. Compared preoperative Glosgow Coma Scale (GCS), light reflex abnormality, midline shift between two groups, old aged group had worse prognostic factors. The overall mortality was 20.3%, old aged group was 33.3% and young aged group was 11.3%. 14 patients (18.7%) of group A had good prognosis, and 62 patients (63.9%) of group B had good prognosis.

Conclusion

This study reveals that traumatic brain injury to the old patients had worse prognostic factors than young patients according to GCS, dilatation of pupils, midline shift, and had higher mortality and poorer outcome than the young patients.

Keywords: Traumatic brain injury, Surgical treatment, Old age, Prognostic factor

Figures and Tables

TABLE 1

Factors related to mortality

GCS: Glasgow Coma Scale, TICH: traumatic intracerebral hemorrhage, ASDH: acute subdural hemorrhage, AEDH: acute epidural hemorrhage

TABLE 2

Factors related to outcome

GCS: Glasgow Coma Scale, TICH: traumatic intracerebral hemorrhage, ASDH: acute subdural hemorrhage, AEDH: acute epidural hemorrhage, GOS: Glasgow Outcome Scale

TABLE 3

Comparison between acute subdural hemorrhage and acute epidural hemorrhage

ASDH: acute subdural hemorrhage, AEDH: acute epidural hemorrhage, GCS: Glasgow Coma Scale, TICH: traumatic intracerebral hemorrhage, GOS: Glasgow Outcome Scale

TABLE 4

Comparison between two groups

GCS: Glasgow Coma Scale, ASDH: acute subdural hemorrhage, AEDH: acute epidural hemorrhage, TICH: traumatic intracerebral hemorrhage

TABLE 5

Mortality of two groups

TABLE 6

Surgical prognosis of two groups

GOS: Glasgow Outcome Scale

References

1. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. Surgical management of acute subdural hematomas. Neurosurgery. 2006; 58:S16–S24. discussion Si-iv.

2. Fell DA, Fitzgerald S, Moiel R, Caram P. Acute subdural hematomas. Review of 144 cases. J Neurosurg. 1975; 42:37–42.

3. Haselsberger K, Pucher R, Auer LM. Prognosis after acute subdural or epidural haemorrhage. Acta Neurochir (Wien). 1988; 90:111–116.

4. Howard MA 3rd, Gross AS, Dacey RG Jr, Winn HR. Acute subdural hematomas: an age-dependent clinical entity. J Neurosurg. 1989; 71:858–863.

5. Jang HS, Lee YB, Chung C, Lee KC, Park YS, Mok JH. Acute subdural hematoma: an analysis of 244 operated case. J Korean Neurosurg Soc. 1996; 25:111–118.

6. Kim ST, Lee JS, Kwon IS, Hong SK, Moon MS. Clinical survey of intracranial acute subdural hematoma. J Korean Neurosurg Soc. 1990; 19:70–78.

7. Koç R, Akdemir H, Oktem IS, Meral M, Menkü A. Acute subdural hematoma: outcome and outcome prediction. Neurosurg Rev. 1997; 20:239–244.

8. Koo HS, Eom KS, Kim DW, Park JT, Moon SK, Kang SD, et al. The analysis of surgical result of traumatic acute subdural hematoma according to age. J Korean Neurotraumatol Soc. 2009; 5:5–10.

9. Kotwica Z, Brzeziński J. Acute subdural haematoma in adults: an analysis of outcome in comatose patients. Acta Neurochir (Wien). 1993; 121:95–99.

10. Langfitt W, Gannarelli TA. Can the out come from head injury be improve? J Neurosurg. 1982; 56:19–25.

11. Lee SW, Kim OL, Woo GB, Kim SH, Bae JH, Choi BY, et al. Prognostic factors in patients with severe head injury. J Korean Neurosurg Soc. 1999; 28:1288–1292.

12. Lee KS, Bae HG, Yun IG. Acute subdural hematoma: analysis of 183 operated cases. J Korean Neurosurg Soc. 1992; 21:983–989.

13. Levi L, Guilburd JN, Lemberger A, Soustiel JF, Feinsod M. Diffuse axonal injury: analysis of 100 patients with radiological signs. Neurosurgery. 1990; 27:429–432.

14. Lewin W, Marshall TF, Robert AH. Long-term outcome after severe head injury. Br Med J. 1979; 2:1533–1538.

15. Lobato RD, Rivas JJ, Cordobes F, Alted E, Perez C, Sarabia R, et al. Acute epidural hematoma: an analysis of factors influencing the outcome of patients undergoing surgery in coma. J Neurosurg. 1988; 68:48–57.

16. Massaro F, Lanotte M, Faccani G, Triolo C. One hundred and twenty-seven cases of acute subdural haematoma operated on. Correlation between CT scan findings and outcome. Acta Neurochir (Wien). 1996; 138:185–191.

17. Oh JS, LeeKS , Kim RS, Doh JW. Outcome of severe acute subdural hematoma. J Korean Neurotraumatol Soc. 2009; 5:1–4.

18. Wilberger JE Jr, Harris M, Diamond DL. Acute subdural hematoma: morbidity, mortality, and operative timing. J Neurosurg. 1991; 74:212–218.

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