Rothweiler B, Temkin N R, Dikmen S S
Department of Rehabilitation Medicine, University of Washington, Seattle 98195-6490, USA.
Arch Phys Med Rehabil. 1998 Aug;79(8):881-7. doi: 10.1016/s0003-9993(98)90082-x.
To examine the effects of age on outcome in persons with traumatic brain injury.
Longitudinal cohort design.
Level I trauma center.
A total of 411 hospitalized subjects with mild to severe traumatic brain injury prospectively studied to 1 year; their age range was 18 to 89 years.
Glasgow Outcome Scale, living situation, and employment.
Increasing age is associated with increasing levels of psychosocial limitations, especially in persons 60 years of age and older. Part of the reason is the greater severity of injury sustained by older persons as reflected in longer coma (despite equivalent initial coma depth) and greater numbers of complications and surgeries for subdural hematomas. However, the consequences of traumatic brain injuries appear to worsen with increasing age at each level of brain injury severity examined, including the milder injuries.
Older adults clearly show less complete recovery 1 year after brain injury than younger adults, either because they have reduced reserves with which to tolerate brain injury or because their physiologic status creates a more destructive injury. Glasgow Coma Scale alone may underestimate the severity of brain injury in the aged as well as its associated consequences. Caution is advised in generalizing findings based principally on younger individuals to older adults with traumatic brain injuries.
研究年龄对创伤性脑损伤患者预后的影响。
纵向队列研究。
一级创伤中心。
411例轻至重度创伤性脑损伤住院患者，前瞻性研究1年；年龄范围为18至89岁。
格拉斯哥预后量表、生活状况和就业情况。
年龄增长与心理社会限制水平增加相关，尤其是60岁及以上人群。部分原因是老年人受伤更严重，表现为昏迷时间更长（尽管初始昏迷深度相同），硬膜下血肿的并发症和手术数量更多。然而，在每个脑损伤严重程度级别中，包括较轻损伤，创伤性脑损伤的后果似乎都随着年龄增长而恶化。
与年轻成年人相比，老年人在脑损伤1年后明显显示出恢复不完全，这可能是因为他们耐受脑损伤的储备能力下降，或者是因为他们的生理状态导致损伤更具破坏性。仅格拉斯哥昏迷量表可能会低估老年人脑损伤的严重程度及其相关后果。建议谨慎将主要基于年轻个体的研究结果推广至创伤性脑损伤的老年人。
