PROGNOSTIC IMPACT OF AGE ON SURGICAL OUTCOMES OF ACUTE TRAUMATIC BRAIN INJURY IN ELDERLY AND SENILE PATIENTS

Abstract

Background. Traumatic brain injury (TBI) in elderly and senile patients is characterized by specific pathomorphological features, atypical clinical presentation, and poor outcomes due to age-related brain involution and high comorbidity burden.
Objective. To assess the prognostic significance of age in the surgical treatment of acute TBI.
Materials and Methods. A retrospective analysis of 1,557 patients surgically treated for acute TBI was performed. The study group included 252 patients aged ≥60 years, and the control group consisted of 1,305 patients aged 18–59 years. Clinical, neuroimaging, and neurological parameters, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS) were analyzed.
Results. Falls from standing height, subdural hematomas, and multiple intracranial injuries predominated in elderly patients. Age ≥60 years was associated with significantly higher postoperative mortality, particularly in the presence of arterial hypotension, severe basal cistern compression, pupillary abnormalities, and postoperative infectious complications. Basal cistern compression showed the highest prognostic value in elderly patients.
Conclusion. Advanced age is an independent adverse prognostic factor in surgical outcomes of severe TBI and should be considered in treatment planning and outcome prediction.