Elderly Patients with Severe Traumatic Brain Injury Could Benefit from Surgical Treatment

Abstract Background Whether aggressive or conservative managements should be used for the elderly patients with severe traumatic brain injury (TBI) remains controversial. This study aimed to assess the outcome of surgical alternatives for treatment of the severe traumatic intracranial hematoma (TIH) in patients aged 65 years or older and identify the factors that may contribute to the outcome. Methods This retrospective study included a cohort of 112 TIH patients. The logistic regression analysis was used to identify independent predictors of unfavorable outcome. The Glasgow Outcome Scale (GOS) was applied to evaluate the outcome. Results Of all the patients aged 65 years or older, 70 (62.5%) were operated. Favorable outcome and mortality of patients receiving operation occurred in 33 (47.1%) patients and 23 (32.9%) patients respectively. Patients with operation were less likely to have unfavorable outcome (52.9% vs.95.2%) and to die (32.9% vs. 88.1%) at 6 months post-injury compared with those treated conservatively. Multivariate logistic regression analysis revealed that lower Glasgow coma scale score (GCS≤5) (P