Mortality risk after head injury increases at 30 years

J Am Coll Surg. 2003 Nov;197(5):711-6. doi: 10.1016/S1072-7515(03)00729-4.


Background: Age has long been recognized as a critical factor in predicting outcomes after head injury, with individuals older than 60 years predicted to have a worse outcome than those younger than 60. The object of this study was to determine the effect of age by decade of life beginning at birth in patients with head injuries of all levels of severity.

Study design: The New York State Trauma Registry was searched for head injuries from January 1, 1994 to December 31, 1995; the 13,908 cases found were placed into age groups by decade. Data were sought for each patient on demographics, Glasgow Coma Score, ICD-9 injury code, New Injury Severity Score (NISS), and mechanism of injury. These data were analyzed with chi-square and one-way ANOVA tests, with significance set at p < 0.05.

Results: The risk of dying was significantly increased in patients beginning at 30 years of age compared with those in the younger age groups, with the greatest increases occurring after age 60 (p < 0.001). For the population with available Glasgow Coma Score data (n = 12,844), the mortality rate for patients ages 0 to 30 was 10.9%, and for patients ages 31 to 50 was 12.4%. The mean Glasgow Coma Score for nonsurvivors ages 0 to 20 (3.9) and for nonsurvivors ages 31 to 50 (5.1) were significantly different, with a risk ratio of 1.3 (p < 0.001).

Conclusions: The risk of dying for patients suffering head injuries increases as early as 30 years of age, making it necessary for health-care providers to consider increased monitoring and treatment for patients in this younger age group.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Brain Injuries / etiology
  • Brain Injuries / mortality*
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Injury Severity Score
  • Male
  • Middle Aged
  • New York / epidemiology
  • Population Surveillance
  • Predictive Value of Tests
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Time Factors
  • Treatment Outcome