For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
1
views
23
references
 Top references
cited by
0
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      342
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      In Patients Over 50 Years, Increased Age Is Associated With Decreased Odds of Documented Loss of Consciousness After a Concussion

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Advanced aged adults have the highest rate of traumatic brain injury (TBI) related hospital admissions, compared to younger age groups. Data were published in 2014 indicating differential injury and neurological responses to a TBI by age categories. In a recent article examining patients with mTBI and isolated subdural hematoma, it was found that older patients had a decreased risk of documented loss of consciousness (LOC). The primary objective was to determine the extent to which the odds of documented LOC changes with increasing age in a population of older adults suffering an isolated concussion and uncomplicated mTBI.

          Methods: This was a retrospective study utilizing 6 years (2010–2015) of National Trauma Data Bank data. This study included patients with (1) diagnosis of concussion; (2) positive or negative loss of consciousness; (3) loss of consciousness durations no longer than 59 min or undefined; (4) age ≥50 years; (5) had a “fall” mechanism of injury; and (6) a valid emergency department Glasgow coma scale 13–15. We excluded patients (1) with any intracranial hemorrhage or intracranial injury of other and unspecified nature; (2) skull fracture; (3) an injury severity scale score >17; (4) a concussion with “unspecified” LOC (ICD-9: 850.9).

          Results: There were 7,466 patients included in the study; the median (IQR) age was 70 (60–80) years. The risk of documented LOC was 71% ( n = 5,319). An 80-year-old had 72% decreased odds of having a documented LOC, compared to a 50-year-old (OR = 0.28, 99.5%CI [0.23–0.34], P < 0.001). This association held when controlling for multiple demographic, comorbid, and clinical variables, and in sensitivity analyses.

          Conclusion: These nationwide data suggest that in patients aged ≥50 years, a significant inverse association exists between age and odds of documented LOC after sustaining a fall-related concussion. Additional studies are needed to validate these findings and to investigate the triad of age, documented LOC, and intracranial hemorrhage. Clinical diagnostic criteria relying on LOC might be at risk of being modified by the association between increasing age and decreasing odds of LOC.

          Related collections

          Most cited references23

          • Record: found
          • Abstract: found
          • Article: not found

          Normal brain development and aging: quantitative analysis at in vivo MR imaging in healthy volunteers.

          E Courchesne, H Chisum, J. Townsend … (2000)
          To quantitate neuroanatomic parameters in healthy volunteers and to compare the values with normative values from postmortem studies. Magnetic resonance (MR) images of 116 volunteers aged 19 months to 80 years were analyzed with semiautomated procedures validated by means of comparison with manual tracings. Volumes measured included intracranial space, whole brain, gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF). Results were compared with values from previous postmortem studies. Whole brain and intracranial space grew by 25%-27% between early childhood (mean age, 26 months; age range, 19-33 months) and adolescence (mean age, 14 years; age range, 12-15 years); thereafter, whole-brain volume decreased such that volunteers (age range, 71-80 years) had volumes similar to those of young children. GM increased 13% from early to later (6-9 years) childhood. Thereafter, GM increased more slowly and reached a plateau in the 4th decade; it decreased by 13% in the oldest volunteers. The GM-WM ratio decreased exponentially from early childhood through the 4th decade; thereafter, it gradually declined. In vivo patterns of change in the intracranial space, whole brain, and GM-WM ratio agreed with published postmortem data. MR images accurately depict normal patterns of age-related change in intracranial space, whole brain, GM, WM, and CSF. These quantitative MR imaging data can be used in research studies and clinical settings for the detection of abnormalities in fundamental neuroanatomic parameters.
          Article 0 comments Cited 214 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Indications for computed tomography in patients with minor head injury.

            M J Haydel, C Preston, T. J. Mills … (2000)
            Computed tomography (CT) is widely used as a screening test in patients with minor head injury, although the results are often normal. We performed a study to develop and validate a set of clinical criteria that could be used to identify patients with minor head injury who do not need to undergo CT. In the first phase of the study, we recorded clinical findings in 520 consecutive patients with minor head injury who had a normal score on the Glasgow Coma Scale and normal findings on a brief neurologic examination; the patients then underwent CT. Using recursive partitioning, we derived a set of criteria to identify all patients who had abnormalities on CT scanning. In the second phase, the sensitivity and specificity of the criteria for predicting a positive scan were evaluated in a group of 909 patients. Of the 520 patients in the first phase, 36 (6.9 percent) had positive scans. All patients with positive CT scans had one or more of seven findings: headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure. Among the 909 patients in the second phase, 57 (6.3 percent) had positive scans. In this group of patients, the sensitivity of the seven findings combined was 100 percent (95 percent confidence interval, 95 to 100 percent). All patients with positive CT scans had at least one of the findings. For the evaluation of patients with minor head injury, the use of CT can be safely limited to those who have certain clinical findings.
            Article 0 comments Cited 189 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              The Canadian CT Head Rule for patients with minor head injury

              Ian G Stiell, George A Wells, Katherine Vandemheen … (2001)
              Article 0 comments Cited 167 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Neurol
                Journal ID (iso-abbrev): Front Neurol
                Journal ID (publisher-id): Front. Neurol.
                Title: Frontiers in Neurology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2295
                Publication date (Electronic): 31 January 2020
                Publication date Collection: 2020
                Volume: 11
                Electronic Location Identifier: 39
                Affiliations
                [1] 1Department of Trauma Research, Swedish Medical Center , Englewood, CO, United States
                [2] 2Department of Trauma Research, Penrose Hospital , Colorado Springs, CO, United States
                [3] 3Department of Trauma Research, Medical City Plano , Plano, TX, United States
                [4] 4Department of Trauma Research, St. Anthony Hospital , Lakewood, CO, United States
                [5] 5Department of Trauma Research, Research Medical Center , Kansas City, MO, United States
                [6] 6Department of Trauma Research, Wesley Medical Center , Wichita, KS, United States
                [7] 7Department of Neurosurgery, Swedish Medical Center , Englewood, CO, United States
                [8] 8Department of Neurosurgery, Medical City Plano , Plano, TX, United States
                [9] 9Department of Trauma Services, Penrose Hospital , Colorado Springs, CO, United States
                [10] 10Department of Neurosurgery, St. Anthony Hospital , Lakewood, CO, United States
                [11] 11Department of Trauma Services, Research Medical Center , Kansas City, MO, United States
                [12] 12Department of Trauma Services, St. Anthony Hospital , Lakewood, CO, United States
                Author notes

                Edited by: Eric Peter Thelin, Karolinska Institutet (KI), Sweden

                Reviewed by: Mikulas Chavko, Naval Medical Research Center, United States; Raquel Gardner, University of California, San Francisco, United States

                *Correspondence: David Bar-Or davidbme49@ 123456gmail.com

                This article was submitted to Neurotrauma, a section of the journal Frontiers in Neurology

                Article
                DOI: 10.3389/fneur.2020.00039
                PMC ID: 7005230
                SO-VID: c5c44d22-f9e3-44e3-9fdc-50e891e711c3
                Copyright © Copyright © 2020 Orlando, Rubin, Panchal, Tanner, Hudson, Harken, Madayag, Berg and Bar-Or.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 29 May 2019
                Date accepted : 10 January 2020
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 25, Pages: 9, Words: 6402
                Categories
                Subject: Neurology
                Subject: Original Research

                ScienceOpen disciplines: Neurology
                Keywords: concussion,loss of consciousness,age,mild,traumatic brain injury,national trauma data bank
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: concussion, loss of consciousness, age, mild, traumatic brain injury, national trauma data bank

                Comments

                Comment on this article