A decade of geriatric traumatic brain injuries in Finland: population-based trends

Author:

Posti Jussi P123,Sipilä Jussi O T345,Luoto Teemu M6,Rautava Päivi78,Kytö Ville9101112

Affiliation:

1. Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland

2. Turku Brain Injury Centre, Turku University Hospital, Turku, Finland

3. Department of Clinical Neurosciences, University of Turku, Finland

4. Division of Clinical Neurosciences, Department of Neurology, Turku University Hospital, Turku, Finland

5. Department of Neurology, Siun sote, North Karelia Central Hospital, Joensuu, Finland

6. Department of Neurosurgery, Tampere University Hospital, Tampere University, Tampere, Finland

7. Clinical Research Center, Turku University Hospital, Turku, Finland

8. Department of Public Health, University of Turku, Turku, Finland

9. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

10. Heart Centre, Turku University Hospital, University of Turku, Turku, Finland

11. Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland

12. Administative Center, Hospital District of Southwest Finland, Turku, Finland

Abstract

Abstract Background we investigated trends of traumatic brain injury (TBI)-related hospitalisations, deaths, acute neurosurgical operations (ANO), and lengths of hospital stay (LOS) in patients aged ≥70 years in Finland using a population-based cohort. Methods nationwide databases were searched for all admissions with a TBI diagnosis as well as later deaths for persons ≥70 years of age during 2004–2014. Results the study period included 20,259 TBI-related hospitalisations (mean age = 80.7 years, men = 48.9%). The incidence of TBI-related hospitalisations was 283/100,000 person-years with an estimated overall annual increase of 2.9% (95% CI: 0.4–5.9%). There was an annual decrease of 2.2% in in-hospital mortality (IHM) in men (95% CI: 0.1–4.3%), with no change in women or overall. There was an annual decrease of 1.1% in odds for ANOs among hospitalised overall (95% CI: 0.1–2.1%) and of 1.4% in men (95% CI: 0.0–2.7%), while no change was observed in women. LOS decreased annually by 2.5% (95% CI: 2.1–2.9%). The incidence of TBI-related deaths was 70/100,000 person-years with an estimated annual increase of 1.6% in women (95% CI: 0.2–2.9%), but no change in men or overall. Mean ages of TBI-related admissions and deaths increased (P < 0.001). Interpretation the incidence rate of geriatric TBI-related hospitalisations increased, especially in women, but LOS and the rate of ANOs among hospitalised decreased. The overall TBI-related mortality remained stable, and IHM decreased in men, while in women, the overall mortality increased and IHM remained stable. However, the overall incidence rates of TBI-related hospitalisations and deaths and the number of cases of IHM were still higher in men.

Funder

Finnish Cultural Foundation

Government’s Special Financial Transfer

Academy of Finland

Finnish Medical Society Duodecim

Science Fund of the City of Tampere

Maire Taposen Foundation

Emil Aaltonen Foundation

Finnish Brain Foundation

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Ageing,General Medicine

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