A study of the functional outcome and mortality in elderly patients with head injuries

The aim of this study was to determine the functional outcome and mortality in relation to the Glasgow coma score (GCS) on presentation in patients aged over 65 years with acute head injury. 2331 patients with head injury were identified by searching the neurosurgery database (1984-1996); 191 met the inclusion criteria and systematic review of medical records was undertaken. Functional outcome on discharge from hospital and mortality were tested statistically against GCS on presentation. Mortality overall was 33.5%. All 59 patients with GCS <11 on presentation had poor outcomes on discharge from hospital. Comparison with outcome for the 132 patients with GCS greater than or equal to 11, of whom 91 had satisfactory outcomes, was highly statistically significant (P<0.001). Elderly patients with presenting GCS <11 due to acute head injury have poor functional outcomes and high mortality rates. Conservative treatment of these patients should be considered. (C) 2000 Harcourt Publishers Ltd.