Characteristics of patients with isolated traumatic brain injury aged ≥60 years, stratified by receipt of ICP monitoring (n=2303)
| ICP, n=66 | No ICP, n=2237 | P value* | |
| Age in years, mean (SD) | 72.2 (8.4) | 77.1 (9.1) | <0.001 |
| Age categories, n (%) | 0.001 | ||
| 60–81 | 55 (83.3) | 1399 (62.5) | |
| >81 | 11 (16.7) | 838 (37.5) | |
| Sex, n (%) | 0.02 | ||
| Female | 24 (36.4) | 1129 (50.5) | |
| Male | 42 (63.6) | 1108 (49.5) | |
| Race, n (%) | 0.03 | ||
| White | 45 (68.2) | 1809 (80.9) | |
| Black | 9 (13.6) | 166 (7.4) | |
| Other | 12 (18.2) | 262 (11.7) | |
| Comorbidities, n (%) | |||
| Neurological | 19 (35.2) | 890 (40.9) | 0.39 |
| Cardiac disease | 44 (81.5) | 1873 (86.3) | 0.31 |
| Respiratory disease | 9 (16.7) | 466 (21.5) | 0.40 |
| Kidney disease | 10 (18.5) | 347 (15.9) | 0.62 |
| Liver disease | 4 (7.4) | 119 (5.5) | 0.54 |
| Anticoagulants at home, n (%) | 10 (15.2) | 445 (19.9) | 0.34 |
| Warfarin | 7 (10.6) | 233 (10.4) | 0.96 |
| Direct oral anticoagulants | 3 (7.0) | 205 (10.0) | 0.51 |
| Antiplatelet use at home, n (%) | 22 (33.3) | 1059 (47.3) | 0.03 |
| Cause of injury, n (%) | <0.001 | ||
| Motor vehicle collision | 14 (21.2) | 176 (7.9) | |
| Fall | 46 (69.7) | 1967 (88.4) | |
| Assault | 5 (7.6) | 34 (1.5) | |
| Other | 1 (1.5) | 47 (2.1) | |
| Head AIS score, n (%) | <0.001 | ||
| 2 | 4 (6.1) | 507 (22.7) | |
| 3 | 8 (12.1) | 882 (39.4) | |
| 4 | 15 (22.7) | 488 (21.8) | |
| 5 | 39 (59.1) | 349 (15.6) | |
| 6 | 0 | 11 (<1) | |
| GCS score†, n (%) | <0.001 | ||
| 13–15 | 11 (16.7) | 1914 (85.6) | |
| 9–12 | 12 (18.2) | 126 (5.6) | |
| <9 | 43 (65.2) | 197 (8.8) | |
| Initial CT results, n (%) | |||
| Subdural hematoma | 54 (81.8) | 1462 (65.4) | 0.01 |
| Epidural hematoma | 5 (7.6) | 56 (2.5) | 0.01 |
| Intraventricular hemorrhage | 16 (24.2) | 163 (7.3) | <0.001 |
| Subarachnoid hemorrhage | 45 (68.2) | 1089 (48.7) | 0.002 |
| Intraparenchymal hemorrhage | 26 (39.4) | 371 (16.6) | <0.001 |
| Cerebral edema | 9 (13.6) | 74 (3.3) | <0.001 |
| Skull fracture | 29 (43.9) | 195 (8.7) | <0.001 |
| CT worsening (any), n (%) | 45 (68.2) | 520 (23.3) | <0.001 |
| Pupil reactivity, n (%) | <0.001 | ||
| Both | 45 (68.2) | 2110 (94.3) | |
| One | 8 (12.1) | 43 (1.9) | |
| Neither | 13 (19.7) | 84 (3.8) | |
| Neurosurgical intervention, n (%) | 31 (47.0) | 178 (8.0) | <0.001 |
| Craniotomy | 20 (30.3) | 128 (5.7) | <0.001 |
| Craniectomy | 10 (15.2) | 30 (1.3) | <0.001 |
| Tracheostomy, n (%) | 17 (25.8) | 40 (1.8) | <0.001 |
| PEG tube/gastrostomy, n (%) | 21 (31.8) | 73 (3.3) | <0.001 |
| Laboratory values, n (%) INR ≥2 | 58 (92.1) | 1814 (91.9) | 0.96 |
| Platelet transfusions, n (%) | 15 (22.7) | 245 (10.9) | 0.003 |
| Reversal agents administered, n (%) | |||
| Vitamin K | 7 (10.6) | 157 (7.0) | 0.26 |
| Fresh frozen plasma | 8 (12.1) | 87 (3.9) | 0.001 |
| Three-factor prothrombin complex concentrate | 1 (1.5) | 25 (1.1) | 0.76 |
| Length of hospital stay in days, median (IQR) | 14 (16) | 4 (5) | <0.001 |
| Length of ICU stay in days, median (IQR) | 12 (10) | 2 (3) | <0.001 |
| Ventilator days, median (IQR) | 6 (9) | 3 (7) | <0.001 |
| Palliative interventions, n (%) | 31 (47.7) | 310 (13.9) | <0.001 |
| Do not attempt resuscitation, n (%) | 18 (27.3) | 191 (8.5) | <0.001 |
| Days from admission, median (IQR) | 5 (3–8) | 1 (1–4) | 0.004 |
| Palliative care consult, n (%) | 11 (16.7) | 128 (5.7) | <0.001 |
| Days from admission, median (IQR) | 6 (2–10) | 2 (1–6) | 0.19 |
| Discontinuation of life-sustaining measures, n (%) | 19 (28.8) | 126 (5.6) | <0.001 |
| Days from admission, median (IQR) | 5 (4–14) | 3 (1–7) | 0.008 |
| Hospice care, n (%) | 1 (1.5) | 100 (4.5) | 0.25 |
| Days from admission, median (IQR) | 3 | 5 (2–8.5) | 0.67 |
| Death at discharge, n (%) | 31 (46.9) | 209 (9.3) | <0.001 |
| Change in residence, n (%) | <0.001 | ||
| More care required/deceased | 59 (89.4) | 993 (44.4) |
*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; INR, international normalized ratio; PEG, percutaneous endoscopic gastrostomy.