Comparison of functional outcomes in elderly who have sustained a minor trauma with or without head injury: a prospective multicenter cohort study

CJEM. 2017 Sep;19(5):329-337. doi: 10.1017/cem.2016.368. Epub 2016 Sep 9.

Abstract

Objectives: The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma.

Methods: This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours. To assess the functional decline, we used a validated test: the Older Americans' Resources and Services Scale. The cognitive function of study patients was also evaluated. Finally, we explored the influence of a concomitant injury on the functional decline in the MT-HI group.

Results: All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR=0.79 [95% CI: 0.55-1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR=0.91 [95% CI: 0.71-1.18]). Furthermore, for the group of patients with a MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR=1.35 [95% CI: 0.71-2.59]).

Conclusion: This study did not demonstrate that the occurrence of a MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury.

Keywords: cognitive status; elderly; functional outcomes; head injury; minor trauma.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Brain Injuries / diagnosis*
  • Brain Injuries / epidemiology*
  • Brain Injuries / therapy
  • Cohort Studies
  • Combined Modality Therapy
  • Comorbidity
  • Confidence Intervals
  • Geriatric Assessment
  • Humans
  • Injury Severity Score
  • Multiple Trauma / diagnosis
  • Multiple Trauma / epidemiology
  • Multiple Trauma / therapy
  • Multivariate Analysis
  • Prognosis
  • Prospective Studies
  • Recovery of Function
  • Treatment Outcome
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / therapy