After experiencing a traumatic brain injury (TBI), older and elderly adults are at higher risk for poor outcomes. According to some estimates, about half of patients older than 55 years old who sustain TBI will die as a result of their injuries, and three-quarters of surviving patients will experience disability and deficits. Researchers have attempted to account for the relationship between old age and poor outcomes after TBI by studying the compounding effect of overlapping symptoms.
Current research has identified that coagulopathy – a bleeding disorder that impairs the blood’s ability to form clots after injury – is associated both with old age and with TBI. A group of researchers in Japan hypothesized that older individuals may experience poorer outcomes after TBI because their ability to recover from injury-related coagulopathy is impaired. To test this hypothesis, they evaluated 274 patients with TBI within twelve hours of initial injury. The researchers recorded the severity of each patient’s TBI and used blood samples to assess variables such as platelet count and plasma levels, which are indicators of clotting ability. They found that patients older than 55 years had higher plasma levels and lower platelet count than their younger counterparts, and that the older patients exhibited poorer outcomes at three months post-injury.
Older adults who sustain TBI are at significantly higher risk of morbidity and mortality than are younger adults, adolescents, and children. Because adults older than 55 years commonly experience impaired blood clotting, they may be poorly equipped to recover from the coagulopathy associated with TBI. Clinicians are urged to consider the role of bleeding disorders in the treatment and rehabilitation of older adults.
Nakae R, Yokobori S, Takamaya Y, et al. Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury. Surigcal Neurology International. (September 2017).