{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:28:28Z","timestamp":1788935308046,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The elderly population constitutes one of the fastest-growing demographic groups globally. Within this population, mild to moderate traumatic brain injuries (TBI) resulting from ground level falls (GLFs) are prevalent and pose significant challenges. Between 50 and 80% of TBIs in older individuals are due to GLFs. These incidents result in more severe outcomes and extended recovery periods for the elderly, even when controlling for injury severity. Given the increasing incidence of such injuries it becomes essential to identify the key factors that predict complications and in-hospital mortality. Therefore, the aim of this study was to pinpoint the top predictors of complications and in-hospital mortality in geriatric patients who have experienced a moderate TBI following a GLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from the American College of Surgeons\u2019 Trauma Quality Improvement Program database. A moderate TBI was defined as a head AIS\u2009\u2264\u20093 with a Glasgow Coma Scale (GCS) 9\u201313, and an AIS\u2009\u2264\u20092 in all other body regions. Potential predictors of complications and in-hospital mortality were included in a logistic regression model and ranked using the permutation importance method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7,489 patients with a moderate TBI were included in the final analyses. 6.5% suffered a complication and 6.2% died prior to discharge. The top five predictors of complications were the need for neurosurgical intervention, the Revised Cardiac Risk Index, coagulopathy, the spine abbreviated injury severity scale (AIS), and the injury severity score. The top five predictors of mortality were head AIS, age, GCS on admission, the need for neurosurgical intervention, and chronic obstructive pulmonary disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When predicting both complications and in-hospital mortality in geriatric patients who have suffered a moderate traumatic brain injury after a ground level fall, the most important factors to consider are the need for neurosurgical intervention, cardiac risk, and measures of injury severity. This may allow for better identification of at-risk patients, and at the same time resulting in a more equitable allocation of resources.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1290201","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T11:27:02Z","timestamp":1702466822000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Predictors of outcomes in geriatric patients with moderate traumatic brain injury after ground level falls"],"prefix":"10.3389","volume":"10","author":[{"given":"Sebastian Peter","family":"Forssten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecka","family":"Ahl Hulme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian Peter","family":"Forssten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Marcelo A. F.","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Sarani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"ref1","volume-title":"Ageing and life course, family and community health WHO global report on falls prevention in older age","year":"2008"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1136\/jech.57.9.740","article-title":"Incidence and costs of unintentional falls in older people in the United Kingdom","volume":"57","author":"Scuffham","year":"2003","journal-title":"J Epidemiol Community Health"},{"key":"ref3","volume-title":"Falls","year":""},{"key":"ref4","volume-title":"Facts about falls | Fall Prevention | Injury Center | CDC","year":"2021"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jsr.2016.05.001","article-title":"The direct costs of fatal and non-fatal falls among older adults\u2014United States","volume":"58","author":"Burns","year":"2016","journal-title":"J Saf Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1089\/neu.2017.5371","article-title":"Geriatric traumatic brain injury: epidemiology, outcomes, knowledge gaps, and future directions","volume":"35","author":"Gardner","year":"2018","journal-title":"J Neurotrauma"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"418","DOI":"10.2176\/nmc.st.2017-0058","article-title":"Clinical characteristics and outcome in elderly patients with traumatic brain injury: for establishment of management strategy","volume":"57","author":"Karibe","year":"2017","journal-title":"Neurol Med Chir"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1097\/CCM.0000000000002991","article-title":"Clinical epidemiology of adults with moderate traumatic brain injury","volume":"46","author":"Watanitanon","year":"2018","journal-title":"Crit Care Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1007\/s12028-016-0253-y","article-title":"Moderate traumatic brain injury: the grey zone of neurotrauma","volume":"25","author":"Godoy","year":"2016","journal-title":"Neurocrit Care"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/1471-2318-13-97","article-title":"Older adults with acquired brain injury: a population based study","volume":"13","author":"Chan","year":"2013","journal-title":"BMC Geriatr"},{"key":"ref11","volume-title":"The world medical association-WMA declaration of Helsinki \u2013 ethical principles for medical research involving human subjects","year":""},{"key":"ref12","doi-asserted-by":"publisher","first-page":"11","DOI":"10.4103\/0974-2700.93102","article-title":"Venous thromboembolic events in isolated severe traumatic brain injury","volume":"5","author":"Mohseni","year":"2012","journal-title":"J Emerg Trauma Shock"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1097\/TA.0b013e31823321f8","article-title":"Effect of the modified Glasgow coma scale score criteria for mild traumatic brain injury on mortality prediction: comparing classic and modified Glasgow coma scale score model scores of 13","volume":"71","author":"Mena","year":"2011","journal-title":"J Trauma"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1161\/01.cir.100.10.1043","article-title":"Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery","volume":"100","author":"Lee","year":"1999","journal-title":"Circulation"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"4481","DOI":"10.1007\/s00068-021-01841-7","article-title":"Mortality risk stratification in isolated severe traumatic brain injury using the revised cardiac risk index","volume":"48","author":"Forssten","year":"2022","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref16","volume-title":"Dementia is a surrogate for frailty in hip fracture mortality prediction - 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