- Research in Gerontological Nursing
- January 2012 - Volume 5 · Issue 1: 17-24
The study aims were to examine the association between age, comorbidity, and cause of injury in older adults with traumatic brain injury (TBI); and to determine which comorbidities relate to mortality, length of stay, and functional outcome at hospital discharge, controlling for initial injury severity, age, and sex. A retrospective cohort study design was used; clinical and outcome trauma registry data were obtained for 196 adults 55 and older with TBI. The majority had at least one comorbid condition (e.g., hypertension, alcohol abuse). In-hospital mortality was 31%. Among the oldest-old, motor vehicle collisions and falls were significantly associated with specific chronic diseases. Prior myocardial infarction was significantly associated with an increased risk of in-hospital death. Injury Severity Score and Glasgow Coma Scale score were predictive of discharge function, but comorbidity did not add significantly to the model. Primary TBI prevention efforts in older adults must consider the impact of comorbidity and cause of injury, particularly in the oldest-old. Alcohol abuse is common in older adults with TBI; screening should be conducted and interventions developed to prevent future injury. Future study is warranted to understand the interplay between pathophysiology of comorbid disease and injury and how to best manage rehabilitation within the context of aging.
Dr. Thompson is Assistant Professor, Biobehavioral Nursing and Health Systems, School of Nursing, Dr. Dikmen is Professor, Department of Rehabilitation Medicine, and Dr. Temkin is Professor, Departments of Biostatistics and Neurosurgery, The University of Washington, Seattle, Washington. Dr. Thompson is also Core Faculty, Harborview Injury Prevention and Research Center, Seattle, Washington.
The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This work was supported in part by the John A. Hartford Foundation (grant 06-202) and the National Institutes of Health (grant KL2RR025015) to Dr. Thompson. Dr. Thompson acknowledges the mentorship of Dr. Sarah H. Kagan during her Claire M. Fagin Fellowship at which time this work was completed.
Address correspondence to Hilaire J. Thompson, PhD, RN, CNRN, FAAN, Assistant Professor, Biobehavioral Nursing and Health Systems, School of Nursing, Box 357266, Seattle, WA 98195-7266; e-mail: firstname.lastname@example.org.
Received: April 09, 2011
Accepted: October 06, 2011
Posted Online: December 14, 2011