Posti Jussi P, Sipilä Jussi O T, Luoto Teemu M, Rautava Päivi, Kytö Ville
Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland.
Turku Brain Injury Centre, Turku University Hospital, Turku, Finland.
Age Ageing. 2020 Aug 24;49(5):779-785. doi: 10.1093/ageing/afaa037.
we investigated trends of traumatic brain injury (TBI)-related hospitalisations, deaths, acute neurosurgical operations (ANO), and lengths of hospital stay (LOS) in patients aged ≥70 years in Finland using a population-based cohort.
nationwide databases were searched for all admissions with a TBI diagnosis as well as later deaths for persons ≥70 years of age during 2004-2014.
the study period included 20,259 TBI-related hospitalisations (mean age = 80.7 years, men = 48.9%). The incidence of TBI-related hospitalisations was 283/100,000 person-years with an estimated overall annual increase of 2.9% (95% CI: 0.4-5.9%). There was an annual decrease of 2.2% in in-hospital mortality (IHM) in men (95% CI: 0.1-4.3%), with no change in women or overall. There was an annual decrease of 1.1% in odds for ANOs among hospitalised overall (95% CI: 0.1-2.1%) and of 1.4% in men (95% CI: 0.0-2.7%), while no change was observed in women. LOS decreased annually by 2.5% (95% CI: 2.1-2.9%). The incidence of TBI-related deaths was 70/100,000 person-years with an estimated annual increase of 1.6% in women (95% CI: 0.2-2.9%), but no change in men or overall. Mean ages of TBI-related admissions and deaths increased (P < 0.001).
the incidence rate of geriatric TBI-related hospitalisations increased, especially in women, but LOS and the rate of ANOs among hospitalised decreased. The overall TBI-related mortality remained stable, and IHM decreased in men, while in women, the overall mortality increased and IHM remained stable. However, the overall incidence rates of TBI-related hospitalisations and deaths and the number of cases of IHM were still higher in men.
我们使用基于人群的队列研究，调查了芬兰70岁及以上患者中创伤性脑损伤（TBI）相关住院、死亡、急性神经外科手术（ANO）以及住院时间（LOS）的趋势。
检索全国性数据库，以获取2004年至2014年期间所有诊断为TBI的住院患者以及70岁及以上患者随后的死亡情况。
研究期间包括20259例TBI相关住院病例（平均年龄 = 80.7岁，男性占48.9%）。TBI相关住院的发生率为283/100000人年，估计总体年增长率为2.9%（95%置信区间：0.4 - 5.9%）。男性的住院死亡率（IHM）每年下降2.2%（95%置信区间：0.1 - 4.3%），女性及总体无变化。住院患者中ANO的发生率总体每年下降1.1%（95%置信区间：0.1 - 2.1%），男性下降1.4%（95%置信区间：0.0 - 2.7%），而女性无变化。LOS每年下降2.5%（95%置信区间：2.1 - 2.9%）。TBI相关死亡的发生率为70/100000人年，估计女性每年增长1.6%（95%置信区间：0.2 - 2.9%），男性及总体无变化。TBI相关住院和死亡的平均年龄增加（P < 0.001）。
老年TBI相关住院率上升，尤其是女性，但住院患者的LOS和ANO率下降。总体TBI相关死亡率保持稳定，男性的IHM下降，而女性的总体死亡率上升且IHM保持稳定。然而，男性的TBI相关住院和死亡的总体发生率以及IHM病例数仍然更高。
