CoChat
Sign Up
Cited by 641Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchTrauma and Emergency Care Studies

The DOI matches its Crossref record; 51 of the 54 references it cites were found in a registry or an index.

Patient age and outcome following severe traumatic brain injury: an analysis of 5600 patients

Open access
Hukkelhoven, Chantal W. P. M., Steyerberg, Ewout W., Rampen, Anneke J. J., Farace, Elana, Habbema, J. Dik F., Marshall, Lawrence F., Murray, Gordon D., Maas, Andrew I. R.·2003·Journal of Neurosurgery
DOI 10.3171/jns.2003.99.4.0666
Open this paper in CoChat — free account

Abstract

Object. Increasing age is associated with poorer outcome in patients with closed traumatic brain injury (TBI). It is uncertain whether critical age thresholds exist, however, and the strength of the association has yet to be investigated across large series. The authors studied the shape and strength of the relationship between age and outcome, that is, the 6-month mortality rate and unfavorable outcome based on the Glasgow Outcome Scale. Methods. The shape of the association was examined in four prospective series with individual patient data (2664 cases). All patients had a closed TBI and were of adult age (96% < 65 years of age). The strength of the association was investigated in a metaanalysis of the aforementioned individual patient data (2664 cases) and aggregate data (2948 cases) from TBI studies published between 1980 and 2001 (total 5612 cases). Analyses were performed with univariable and multivariable logistic regression. Proportions of mortality and unfavorable outcome increased with age: 21 and 39%, respectively, for patients younger than 35 years and 52 and 74%, respectively, for patients older than 55 years. The association between age and both mortality and unfavorable outcome was continuous and could be adequately described by a linear term and expressed even better statistically by a linear and a quadratic term. The use of age thresholds (best fitting threshold 39 years) in the analysis resulted in a considerable loss of information. The strength of the association, expressed as an odds ratio per 10 years of age, was 1.47 (95% confidence interval [CI] 1.34–1.63) for death and 1.49 (95% CI 1.43–1.56) for unfavorable outcome in univariable analyses, and 1.39 (95% CI 1.3–1.5) and 1.46 (95% CI 1.36–1.56), respectively, in multivariable analyses. Thus, the odds for a poor outcome increased by 40 to 50% per 10 years of age. Conclusions. An older age is continuously associated with a worsening outcome after TBI; hence, it is disadvantageous to define the effect of age on outcome in a discrete manner when we aim to estimate prognosis or adjust for confounding variables.

Overview

Integrity signals

Registry

Crossref · 10.3171/jns.2003.99.4.0666

Cites

51 of 51 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

The text we found for this paper looks like another document, so its claims and self-check weren’t run. The registry and citation checks still apply.

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The text we found for this paper looks like another document, so the self-check wasn’t run.

Citations

Cites

Show all 54 references

Cited by

Sorted by citations

Items 601–641 of 641

Related

See all

Metadata

Authors
Hukkelhoven, C. W. P. M., Steyerberg, E. W., Rampen, A. J. J., Farace, E., Habbema, J. D. F., Marshall, L. F., Murray, G. D., & Maas, A. I. R.
Affiliations
Erasmus MC (NL)
ORCID
Venue
Journal of Neurosurgery
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Published
2003-10
Volume
99
Issue
4
Pages
666-673
ISSN
0022-3085 (ISSN-L)
DOI
10.3171/jns.2003.99.4.0666
OpenAlex
W2119835440
Cited by
641
References
54
Citations by year
2026: 19 · 2025: 22 · 2024: 22 · 2023: 32 · 2022: 41 · 2021: 24 · 2020: 32 · 2019: 45 · 2018: 38 · 2017: 44 · 2016: 28 · 2015: 36 · 2014: 33 · 2013: 34 · 2012: 46
FWCI
1.20
Type
journal article
Language
en
Open access
Locations
  • Journal of neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • Socio-Environmental Systems Modeling (acceptedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
Keywords
traumatic brain injury, patient age, mortality, Glasgow Outcome Scale, prognostic factors, age limits, individual patient data
MeSH terms
Adult, Age Factors, Aged, Brain Injuries, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Glasgow Coma Scale, Survival Rate, Multivariate Analysis, Logistic Models

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review