New tool predicts outcomes in elderly traumatic brain injury patients

Editor's Note

Researchers at Wake Forest University, Winston-Salem, North Carolina, have developed a tool that helps predict the possibility of survival and independence at discharge for elderly patients with traumatic brain injury.

The tool, which accounts for variables such as age, gender, and severity of brain injury, was evaluated in 57,588 patients in the National Trauma Data Bank, and then tested on 894 patients in the Wake Forest institutional trauma registry over a 4-year period.

The survival and independence at discharge models showed excellent discrimination. Independence and survival generally decreased by decade, respectively: Age 50-59 (80%, 6.5%), 60-69 (82%, 7.0%), 70-79 (76%, 8.9%), and 80-89 (67%, 13.4%).

The tool provides important data to family members when addressing goals of care, the authors say.

Outcomes after brain injury worsen with age, leading to questions of futility of care among caregivers and surrogate decision makers of elderly, brain injured patients. Using the National Trauma Data Bank we developed a predictive tool for probable outcomes in this population that may be used to facilitate such conversations.