Traumatic Brain Injury Risks and Mortality in the Geriatric Patient: A Swedish Perspective

Ayham Kadi and Shahzad Akram

Department of Physiology and Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden

^*Correspondance to: Shahzad Akram 

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Abstract:

Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in older adults. In high-income settings, falls are the predominant mechanism; however, contemporary Scandinavian data describing injury characteristics and short-term outcomes are limited. Methods: We performed a retrospective cohort study of patients aged >65 years with TBI treated at Karolinska University Hospital between 2019 and 2023, using the hospital Trauma Registry with supplementary chart review. Patients without Swedish identification numbers, prehospital deaths, and chronic haemorrhages were excluded. We described demographics, injury mechanisms, traumatic intracranial haemorrhage (tICH) subtypes, and 30-day mortality, and evaluated clinical factors associated with death. Results: The cohort comprised 722 patients; falls accounted for 77.8% of injuries. Overall, 30-day mortality was 18.3%. Advanced age, severe injury, and pre-injury antithrombotic therapy were associated with higher 30-day mortality (p<0.05); the presence of tICH was also associated with increased mortality risk. Subdural haemorrhage was the most frequent tICH subtype (30.6%). Epidural haemorrhage showed the strongest association with mortality (OR 2.8; p=0.035). Conclusions: Among older adults with TBI treated at a Swedish level I trauma centre, falls were the dominant injury mechanism and short-term mortality was substantial. Mortality was higher in patients of advanced age, with severe injury, receiving antithrombotic therapy, and with tICH, with heterogeneity by haemorrhage subtype. These findings support the importance of fall-prevention strategies and underscore the need for careful management of antithrombotic therapy in older adults at risk for TBI.

Keywords:

Traumatic brain injury; Geriatric; Mortality; Trauma register; Intracranial haemorrhages

Cite the Article:

Kadi A, Akram S. Traumatic Brain Injury Risks and Mortality in the Geriatric Patient: A Swedish Perspective. World J Surg Surgical Res. 2026; 9: 1624..