College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
College of Medicine & Health Sciences, Oman Medical Specialty Board, Muscat, Sultanate of Oman.
World Neurosurg. 2024 Jan;181:e990-e1000. doi: 10.1016/j.wneu.2023.11.025. Epub 2023 Nov 10.
Traumatic brain injury (TBI) in the geriatric population is a serious public health problem and has a huge impact on mortality and morbidity.
A retrospective cohort study including patients aged above 65 admitted to a tertiary specialized trauma center, in the period from January 2016 to 31 December 2019. The data collected include patients' demographics, diagnosis, Glasgow Coma Scale (GCS) on arrival, length of stay, investigations, and type of surgery done.
Total number of TBI cases in our study is 145. The most frequent single diagnosis was subdural hematoma (85). Subsequently, it was the costliest diagnosis with an average cost of 3569 USD per patient. Length of stay on average was 17.11 ± 41 hours, with the majority (109 patients) having nonprolonged hospital stay (<14 days). Most of those managed by observation have below-average costs compared to other patients (P < 0.001). Complete blood count was the highly requested test with a total cost 5070 $ in the study period. And head computed tomography had the highest total cost 58,864 $. 21 craniotomies and 30 burr holes were made with a total cost of 30,000 and 25,325 respectively. Patients with lower GCS (64.6%) have below-average hospitalization costs compared to those who got high GCS scores (P < 0.001).
This study provides the first estimates of the financial burden of Geriatric TBI in the region, which signifies the importance of developing strategies to prevent TBIs and help in resource allocation and healthcare policy formation.
老年人群的创伤性脑损伤(TBI)是一个严重的公共卫生问题,对死亡率和发病率有巨大影响。
这是一项回顾性队列研究,纳入了 2016 年 1 月至 2019 年 12 月期间在一家三级专科创伤中心就诊的年龄在 65 岁以上的患者。收集的数据包括患者的人口统计学特征、诊断、入院时的格拉斯哥昏迷量表(GCS)评分、住院时间、检查和所行手术类型。
本研究共纳入 145 例 TBI 患者。最常见的单一诊断是硬膜下血肿(85 例)。其次,它是最昂贵的诊断,每位患者的平均费用为 3569 美元。平均住院时间为 17.11±41 小时,大多数(109 例)患者的住院时间较短(<14 天)。与其他患者相比,接受观察治疗的患者的平均费用较低(P<0.001)。研究期间,总费用为 5070 美元的全血细胞计数是需求量最大的检查。头部 CT 总费用最高,为 58864 美元。共进行了 21 次开颅术和 30 次颅骨钻孔术,总费用分别为 30000 美元和 25325 美元。与 GCS 评分较高的患者相比,GCS 评分较低(64.6%)的患者的住院费用较低(P<0.001)。
本研究首次估计了该地区老年 TBI 的经济负担,这表明制定预防 TBI 的策略、帮助资源分配和制定医疗保健政策的重要性。