Abstract：
Traumatic brain injury (TBI) poses a particular health risk for the elderly. The recently developed elderly TBI (eTBI) score combines the prognostic information of the risk factors characteristic of the geriatric population. We aimed to determine its validity and reliability on an independent sample.
We present a retrospective analysis of 506 consecutive patients after TBI aged ≥65 years. The previously described nomogram and the eTBI score were used. The primary outcome measure was mortality or vegetative state at 30 days after hospital admission.
Mortality or vegetative state rate was 21.3%. The nomogram and eTBI Score showed similar predictive performance with accuracy of 83.8% (95% confidence interval 80.2%-87%) and 84.4% (95% confidence interval 80.8%-87.6%), respectively. On the basis of the Youden index and C4.5 algorithm, we divided patients according to the 3-tier pattern into low-, high-, and medium-risk groups. The outcome prediction in the first 2 groups was correct in 93.1% (survival in the low-risk group) and 94.4% (mortality in the high-risk group). Patients included in the medium-risk group usually required surgical treatment (85.3%) and were characterized by increased mortality or vegetative state (55%). Among patients with eTBI ≥5 (n = 221), there was no difference in outcome between those treated conservatively and surgically.
This is the first study confirming the validity of the eTBI Score and its close association with outcome of geriatric population after TBI. The novel 3-tier risk stratification scheme was applicable to both conservatively and surgically treated patients.
We present a retrospective analysis of 506 consecutive patients after TBI aged ≥65 years. The previously described nomogram and the eTBI score were used. The primary outcome measure was mortality or vegetative state at 30 days after hospital admission.
Mortality or vegetative state rate was 21.3%. The nomogram and eTBI Score showed similar predictive performance with accuracy of 83.8% (95% confidence interval 80.2%-87%) and 84.4% (95% confidence interval 80.8%-87.6%), respectively. On the basis of the Youden index and C4.5 algorithm, we divided patients according to the 3-tier pattern into low-, high-, and medium-risk groups. The outcome prediction in the first 2 groups was correct in 93.1% (survival in the low-risk group) and 94.4% (mortality in the high-risk group). Patients included in the medium-risk group usually required surgical treatment (85.3%) and were characterized by increased mortality or vegetative state (55%). Among patients with eTBI ≥5 (n = 221), there was no difference in outcome between those treated conservatively and surgically.
This is the first study confirming the validity of the eTBI Score and its close association with outcome of geriatric population after TBI. The novel 3-tier risk stratification scheme was applicable to both conservatively and surgically treated patients.
摘要：
创伤性脑损伤（TBI）对老年人构成特殊的健康风险。最近开发的老年TBI（eTBI）评分结合了老年人群特有的危险因素的预后信息。我们旨在确定其在独立样本上的有效性和可靠性。
我们对506例年龄≥65岁的TBI患者进行了回顾性分析。使用先前描述的列线图和eTBI评分。主要结局指标是入院后30天的死亡率或植物人状态。
死亡率或植物状态率为21.3%。列线图和eTBI评分显示出相似的预测性能，准确率分别为83.8%(95%置信区间80.2%-87%)和84.4%(95%置信区间80.8%-87.6%)。分别。在Youden指数和C4.5算法的基础上,我们根据三层模式将患者分为低，high,中等风险人群。前两组的结果预测正确，分别为93.1％（低风险组的生存率）和94.4％（高风险组的死亡率）。中等风险组的患者通常需要手术治疗（85.3％），其特征是死亡率或植物状态增加（55％）。在eTBI≥5的患者中（n=221），保守治疗和手术治疗的结果没有差异.
这是第一项研究，证实了eTBI评分的有效性及其与TBI后老年人群预后的密切关系。新的3层风险分层方案适用于保守治疗和手术治疗的患者。
我们对506例年龄≥65岁的TBI患者进行了回顾性分析。使用先前描述的列线图和eTBI评分。主要结局指标是入院后30天的死亡率或植物人状态。
死亡率或植物状态率为21.3%。列线图和eTBI评分显示出相似的预测性能，准确率分别为83.8%(95%置信区间80.2%-87%)和84.4%(95%置信区间80.8%-87.6%)。分别。在Youden指数和C4.5算法的基础上,我们根据三层模式将患者分为低，high,中等风险人群。前两组的结果预测正确，分别为93.1％（低风险组的生存率）和94.4％（高风险组的死亡率）。中等风险组的患者通常需要手术治疗（85.3％），其特征是死亡率或植物状态增加（55％）。在eTBI≥5的患者中（n=221），保守治疗和手术治疗的结果没有差异.
这是第一项研究，证实了eTBI评分的有效性及其与TBI后老年人群预后的密切关系。新的3层风险分层方案适用于保守治疗和手术治疗的患者。
