Neurosurgical management of geriatric patients with traumatic brain injury in a medium-developed Chinese city: a recent-years overview.

Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide, with outcomes influenced by age and comorbidities. This study aimed to compare the clinical characteristics, surgical management, and outcomes of elderly and younger TBI patients. Methods: Between 2017 and 2022, 1,260 TBI patients admitted to our hospital were included and categorized into younger (18-59 years) and elderly (≥60 years) groups. Demographic data, injury mechanisms, types of brain trauma, surgical interventions, and discharge outcomes were analyzed. Results: Elderly patients had higher rates of comorbidities, with traffic accidents as the leading cause of injury and falls predominating in those aged ≥75 years. They showed a higher proportion of subdural hemorrhages, higher preoperative GCS scores, and required more mechanical ventilation and tracheostomy but underwent fewer decompressive craniectomies. In-hospital mortality was slightly lower in the elderly group, whereas rates of vegetative state and moderate-to-severe disability were higher, reflecting age-related differences in clinical outcomes and surgical management. Conclusions: Age significantly influences the clinical presentation, management strategies, and functional outcomes of TBI patients. Tailored surgical and postoperative care are crucial for optimizing survival and quality of life in elderly patients.