Characteristics of patients with isolated traumatic brain injury aged ≥60 years and meeting the Brain Trauma Foundation guidelines for ICP monitoring, by ICP status (n=240)
| ICP, n=43 | No ICP, n=197 | P value* | |
| Age in years, mean (SD) | 71.2 (7.4) | 75.6 (9.1) | 0.004 |
| Age categories, n (%) | 0.01 | ||
| 60–81 | 38 (88.4) | 137 (69.5) | |
| >81 | 5 (11.6) | 60 (30.5) | |
| Sex, n (%) | 0.19 | ||
| Female | 15 (34.9) | 90 (45.7) | |
| Male | 28 (65.1) | 107 (54.3) | |
| Race, n (%) | 0.17 | ||
| White | 27 (62.8) | 151 (76.7) | |
| Black | 7 (16.3) | 19 (9.6) | |
| Other | 9 (20.9) | 27 (13.7) | |
| Comorbidities, n (%) | |||
| Neurological | 13 (37.1) | 66 (36.3) | 0.92 |
| Cardiac disease | 26 (74.3) | 147 (80.8) | 0.38 |
| Respiratory disease | 5 (14.3) | 40 (21.9) | 0.30 |
| Kidney disease | 6 (17.1) | 22 (12.1) | 0.41 |
| Liver disease | 2 (5.7) | 10 (5.5) | 0.96 |
| Anticoagulants at home, n (%) | 6 (13.9) | 42 (21.3) | 0.27 |
| Warfarin | 4 (9.3) | 25 (12.7) | 0.54 |
| Direct oral anticoagulants | 2 (7.1) | 15 (10.0) | 0.64 |
| Antiplatelet use at home, n (%) | 10 (23.3) | 68 (34.5) | 0.15 |
| Cause of injury, n (%) | 0.05 | ||
| Motor vehicle collision | 10 (23.3) | 21 (10.9) | |
| Fall | 30 (69.8) | 164 (84.9) | |
| Assault | 2 (4.7) | 2 (1.0) | |
| Other | 1 (2.3) | 6 (3.1) | |
| Head AIS score, n (%) | 0.73 | ||
| 2 | 1 (2.3) | 9 (4.6) | |
| 3 | 6 (13.9) | 36 (18.3) | |
| 4 | 9 (20.9) | 35 (17.8) | |
| 5 | 27 (62.8) | 113 (57.4) | |
| 6 | 0 | 4 (2.0) | |
| GCS score†, n (%) | 0.12 | ||
| 3 | 17 (39.5) | 108 (54.8) | |
| 4 | 5 (11.6) | 11 (5.6) | |
| 5 | 2 (4.7) | 7 (3.6) | |
| 6 | 3 (6.9) | 28 (14.2) | |
| 7 | 9 (20.9) | 21 (10.7) | |
| 8 | 7 (16.3) | 22 (11.2) | |
| Initial CT results, n (%) | |||
| Subdural hematoma | 36 (83.7) | 160 (81.2) | 0.70 |
| Epidural hematoma | 4 (9.3) | 12 (6.1) | 0.44 |
| Intraventricular hemorrhage | 10 (23.3) | 33 (16.8) | 0.31 |
| Subarachnoid hemorrhage | 30 (69.8) | 103 (52.3) | 0.04 |
| Intraparenchymal hemorrhage | 18 (41.9) | 44 (22.3) | 0.01 |
| Cerebral edema | 7 (16.3) | 29 (14.7) | 0.79 |
| Skull fracture | 23 (53.5) | 39 (19.8) | <0.001 |
| CT worsening (any), n (%) | 27 (62.8) | 80 (40.6) | 0.01 |
| Pupil reactivity, n (%) | 0.37 | ||
| Both | 24 (55.8) | 105 (53.3) | |
| One | 6 (13.9) | 16 (8.12) | |
| Neither | 13 (30.2) | 76 (38.6) | |
| Neurosurgical intervention, n (%) | 23 (53.5) | 50 (25.4) | <0.001 |
| Craniotomy | 15 (34.9) | 37 (18.8) | 0.02 |
| Craniectomy | 8 (18.6) | 15 (7.6) | 0.03 |
| Tracheostomy, n (%) | 12 (27.9) | 11 (5.6) | <0.001 |
| PEG tube/gastrostomy, n (%) | 14 (32.6) | 21 (10.7) | <0.001 |
| Platelet transfusion, n (%) | 7 (16.3) | 36 (18.3) | 17.9 |
| Reversal agents administered, n (%) | |||
| Vitamin K | 5 (23.8) | 16 (8.1) | 0.46 |
| Fresh frozen plasma | 7 (16.3) | 34 (17.3) | 0.88 |
| Three-factor prothrombin complex concentrate | 43 (100) | 196 (99.5) | 0.64 |
| Length of hospital stay in days, median (IQR) | 12 (20) | 5 (8) | <0.001 |
| Length of ICU stay in days, median (IQR) | 10.5 (10) | 4 (7) | <0.001 |
| Ventilator days, median (IQR) | 6.5 (10) | 3 (6) | <0.001 |
| Palliative interventions, n (%) | 20 (47.6) | 107 (54.6) | 0.41 |
| Do not attempt resuscitation, n (%) | 14 (32.6) | 65 (33.0) | 0.96 |
| Days from admission, median (IQR) | 5 (3–9) | 1 (1–4) | 0.002 |
| Palliative care consult, n (%) | 7 (16.3) | 38 (19.3) | 0.65 |
| Days from admission, median (IQR) | 6 (2–11) | 2 (1–5) | 0.17 |
| Discontinuation of life-sustaining measures, n (%) | 13 (30.2) | 66 (33.5) | 0.68 |
| Days from admission, median (IQR) | 5 (5–14) | 2 (1–5) | 0.002 |
| Hospice care, n (%) | 0 | 23 (11.7) | 0.02 |
| Days from admission, median (IQR) | n/a | 2 (2–6) | n/a |
| Death at discharge, n (%) | 23 (53.5) | 118 (59.9) | 0.44 |
| Change in residence, n (%) | 0.97 | ||
| More care required/deceased | 39 (90.7) | 179 (90.9) |
*P value comparing across age categories from Student’s t-test, Wilcoxon rank-sum, or χ2 goodness of fit.
†Best postresuscitation GCS score.
AIS, Abbreviated Injury Scale; GCS, Glasgow Coma Scale; ICP, intracranial pressure; ICU, intensive care unit; n/a, not available; PEG, percutaneous endoscopic gastrostomy.