Complications affecting the functional outcome after 1 year in older adults with severe head injury

Author:

Lin Ming-Hsiu,Lu Chih-Cheng,Chang Chia-Hao1,Tsai Tsung-Chih2

Affiliation:

1. Division of Traumatology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan, Taiwan

2. Department of Surgery, Chi Mei Medical Center, Liouying, Tainan, Taiwan.

Abstract

Abstract Background This study explored possible significant complications, which affected the functional outcome after 1-year follow-up in older adults with severe head injury. Methods Retrospective secondary data were collected from the hospital medical information system. The patients who suffered from severe head injury (Injury Severity Score [ISS] ≧16) with the disease classification system were collected in the study. The survived patients were followed by telephone 1 year after discharge. Documented complications, Glasgow Outcome Scale, and Functional Independence Measure were used for comparisons. This study protocol was approved by the institutional review board of the hospital. Results Between January 2009 and September 2015, patients who were 65 years and older, diagnosed with ISS ≧16, were enrolled. There were 142 patients collected, and 60 patients survived reachable for more than 1 year for follow-up and analysis. The mean age of collected survival was 75.2 ± 6.1 years. Both complications of pneumonia and urinary tract infection had worsened the outcome of the older patients after 1-year follow-up (P < 0.001). After 1 year, those who had complications with urinary tract infection but not pneumonia had a worse prognosis in the aspects of functional outcome in 1-year follow-up. Conclusions Older adults with severe head injuries often have high mortality. When they survived, independent life activities are critical for their quality of life. Urinary tract infections during admission have detrimental effects on the functional outcome in the older patients. Prevention of urinary tract infection is encouraged for better outcome in older patients with severe head injury.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

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