Department of Neurology, Jessa Hospital, Hasselt, Belgium.
Department of general medicine, SBOH, Utrecht, The Netherlands.
Brain Inj. 2022 Jul 29;36(9):1118-1122. doi: 10.1080/02699052.2022.2109731. Epub 2022 Aug 17.
To investigate the influence of frailty in elderly with severe TBI on mortality and functional outcome.
126 patients with TBI aged 60 years or older and with a presenting Glasgow Coma Scale score of 8 or lower were retrospectively included. To investigate frailty, we used the CSHA Clinical Frailty Scale. The primary outcome measures were mortality, and the secondary outcome measures were Glasgow Outcome Scale Extended (GOSE) at discharge and GOSE at 6 months after trauma.
High frailty was a significant predictor for mortality (OR 2.38, p 0.047), if adjusted for the injury severity scale. High frailty was also a significant predictor for poor functional outcome after 6 months (OR 4.35, p 0.03). After 6 months, the GOSE of the low frailty group was significantly higher than in the high frailty group (p 0.019). Also, the improvement of the GOSE was significant in the low frailty group (p 0.007), while in the high frailty group there was no significant improvement of the GOSE (p 0.546) after 6 months.
Frailty has a significant impact on outcome in elderly with severe TBI. There is a higher mortality in the frail elderly and there is less recovery after TBI.
探讨老年严重创伤性脑损伤（TBI）患者的虚弱状况对死亡率和功能结局的影响。
回顾性纳入 126 例年龄≥60 岁且格拉斯哥昏迷量表（GCS）评分为 8 分或更低的 TBI 患者。为了评估虚弱状况，我们使用了加拿大老年人健康评估研究临床虚弱量表（CSHA-CFS）。主要结局指标为死亡率，次要结局指标为创伤后出院时的格拉斯哥结局量表扩展（GOSE）评分和 6 个月时的 GOSE 评分。
高虚弱程度是死亡率的显著预测因素（OR 2.38，p=0.047），如果调整损伤严重程度评分，则更是如此。高虚弱程度也是 6 个月后功能结局不良的显著预测因素（OR 4.35，p=0.03）。6 个月后，低虚弱组的 GOSE 评分显著高于高虚弱组（p=0.019）。此外，低虚弱组的 GOSE 评分改善显著（p=0.007），而高虚弱组在 6 个月后 GOSE 评分无显著改善（p=0.546）。
虚弱状况对老年严重 TBI 患者的结局有显著影响。虚弱的老年患者死亡率更高，创伤后恢复程度更低。
