Evidence map›Paper›PMID 39799536›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Hospital admission of older patients with mild traumatic brain injury and traumatic intracranial hemorrhage: is it always necessary?

Juliette A L Santing, Maxime Van Gent, Crispijn L Van Den Brand, Joukje Van Der Naalt, Korné Jellema

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Juliette A L SantingDepartment of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK, The Hague, The Netherlands. j.a.l.santing@umcg.nl.
Maxime Van GentDepartment of Neurology, Alrijne Hospital, PO Box 4220, 2350 CC, Leiderdorp, The Netherlands.
Crispijn L Van Den BrandDepartment of Emergency Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Joukje Van Der NaaltDepartment of Neurology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Korné JellemaDepartment of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK, The Hague, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and importanceTraumatic intracranial hemorrhage (tICH) after mild traumatic brain injury (mTBI) is not uncommon in the elderly. Often, these patients are admitted to the hospital for observation. The necessity of admission in the absence of clinically important intracranial injuries is however unclear.

objectivesThe objective of this study is to identify which factors additional to tICH affect the risk of this outcome and to evaluate the differences in the risk of adverse outcome in younger and older mTBI patients with tICH. DESIGN, SETTING, AND

participantsThis retrospective study assessed adult (≥ 16 years) mTBI patients with tICH admitted to a Level 1 trauma center between January 2017 and October 2020. OUTCOME MEASURES AND ANALYSIS: Patients were stratified into two groups, age < 65 years and age ≥ 65 years. Adverse outcome due to tICH was assessed using a composite adverse outcome which comprised either, a drop in GCS by more than 1 point, progression of or new neurological deficits, seizure activity, progression of tICH on repeated neuroimaging after clinical deterioration, a neurosurgical intervention, a readmission within three months of injury related to TBI, or death. Logistic regression analysis was used to identify independent predictors of the composite adverse outcome. MAIN

resultsIn total, 332 mTBI patients with tICH were enrolled in our study. Older mTBI patients with tICH met the criteria for the composite adverse outcome significantly more often than younger patients (12.6% 95% CI 8.0-17.0% vs. 4.9%, 95% CI 1.0-9.0%, p = 0.033). The univariate analysis showed that a neurological deficit (OR 6.55, 95% CI 2.37-18.08) or a SDH on admission (OR 3.13, 95% CI 1.40-6.99) was positively associated with the composite adverse outcome in older patients. The presence of isolated traumatic SAH (tSAH) was associated with a decreased risk of the composite adverse outcome (OR 0.10, 95% CI 0.01-0.71). Multivariate analysis was not possible.

conclusionSerious adverse outcomes are frequently observed in older mTBI patients with tICH. Nonetheless, our findings suggest that older patients with an isolated tSAH are at low-risk for deterioration and may be directly discharged from the ED after a short period of observation.

Indexed as

Brain ConcussionHospitalizationIntracranial Hemorrhage, TraumaticPatient AdmissionAdultAgedAged, 80 and overAge FactorsFemaleGlasgow Coma ScaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTrauma CentersHospital admissionMild traumatic brain injuryOlder adultsTraumatic intracranial hemorrhage

Identifiers

PMID39799536
PMCPMC11725537

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.