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dc.contributor.authorKehoe, A
dc.contributor.authorSmith, JE
dc.contributor.authorBouamra, O
dc.contributor.authorEdwards, A
dc.contributor.authorYates, D
dc.contributor.authorLecky, F
dc.date.accessioned2016-04-22T12:08:51Z
dc.date.available2016-04-22T12:08:51Z
dc.date.issued2016-06
dc.identifier.issn1472-0205
dc.identifier.issn1472-0213
dc.identifier.urihttp://hdl.handle.net/10026.1/4533
dc.description.abstract

INTRODUCTION: Recent evidence suggests that presenting GCS may be higher in older rather than younger patients for an equivalent anatomical severity of traumatic brain injury (TBI). The aim of this study was to confirm these observations using a national trauma database and to test explanatory hypotheses. METHODS: The Trauma Audit Research Network database was interrogated to identify all adult cases of severe isolated TBI from 1988 to 2013. Cases were categorised by age into those under 65 years and those 65 years and older. Median presenting GCS was compared between the groups at abbreviated injury score (AIS) level (3, 4 and 5). Comparisons were repeated for subgroups defined by mechanism of injury and type of isolated intracranial injury. RESULTS: 25 082 patients with isolated TBI met the inclusion criteria, 10 936 in the older group and 14 146 in the younger group. Median or distribution of presenting GCS differed between groups at each AIS level. AIS 3: 14 (11-15) vs 15 (13-15), AIS 4: 14 (9-15) vs 14 (13-15), AIS 5: 9 (4-14) vs 14 (5-15) all p<0.001. Similar differences between the groups were observed across all mechanisms of injury and types of isolated intracranial injury. We detected no influence of gender on results. CONCLUSIONS: For an equivalent severity of intracranial injury, presenting GCS is higher in older patients than in the young. This observation is unlikely to be explained by differences in mechanism of injury or types of intracranial injury between the two groups.

dc.format.extent381-385
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoeng
dc.publisherBMJ
dc.subjectTrauma, head
dc.subjecttriage
dc.subjectAdult
dc.subjectAge Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectBrain Injuries, Traumatic
dc.subjectEngland
dc.subjectFemale
dc.subjectGlasgow Coma Scale
dc.subjectHumans
dc.subjectInjury Severity Score
dc.subjectMale
dc.subjectMiddle Aged
dc.titleOlder patients with traumatic brain injury present with a higher GCS score than younger patients for a given severity of injury
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/26825613
plymouth.issue6
plymouth.volume33
plymouth.publisher-urlhttp://dx.doi.org/10.1136/emermed-2015-205180
plymouth.publication-statusPublished
plymouth.journalEmergency Medicine Journal
dc.identifier.doi10.1136/emermed-2015-205180
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Users by role
dc.publisher.placeEngland
dcterms.dateAccepted2015-12-29
dc.identifier.eissn1472-0213
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1136/emermed-2015-205180
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2016-06
rioxxterms.typeJournal Article/Review


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