• Kunal P Kanakia, Anne Marie Wells, Missak Tchoulhakian, Brian S Iskra, Christian Kaculini, Samon Tavakoli-Samour, Jacob T Boyd, Shaheryar Hafeez, Ali Seifi, and Bradley A Dengler.
• Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
• World Neurosurg. 2022 Feb 1; 158: e441-e450.

Background And ObjectiveGeriatric patients (age ≥65 years) who sustain a traumatic brain injury have an increased risk of poor outcomes and higher mortality compared with younger cohorts. We aimed to evaluate the risk factors for discharge outcomes in a geriatric traumatic subdural hematoma population, stratified by age and pretraumatic medical comorbidities. This was a single-center retrospective cohort study of geriatric patients (N = 207).MethodsPatient charts were evaluated for factors including patient characteristics, comorbidities, injury-related and seizure-related factors, neurosurgical intervention, and patient disposition on discharge.ResultsBivariate and multivariate analyses showed that age was nonpredictive of patient outcomes. Underlying vasculopathic comorbidities were the primary determinant of posttraumatic seizure, surgical, and discharge outcomes. Multifactor analysis showed that patients who went on to develop status epilepticus (n = 11) had a higher frequency of vasculopathic comorbidities with strong predictive power in poor patient outcomes.ConclusionsOur findings suggest a need to establish unique prognostic risk factors based on patient outcomes that guide medical and surgical treatment in geriatric patients.Published by Elsevier Inc.

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