A-04 Signs of Injury, Preexisting Health Conditions, and Emergency Department Discharge Location among Older Adults with Mild Traumatic Brain Injuries

Objective

Preexisting health conditions are associated with worse outcome following mild traumatic brain injury (MTBI), which is especially important in MTBI management among older adults. This study focused on older adults who presented to an emergency department (ED) following uncomplicated MTBI, examining the relationship between clinical signs of MTBI, preexisting conditions, and the location of ED discharge.

Method

Participants included older adults (n = 616, men = 44.8%, ≥55 years-old) who presented to the Tampere University Hospital ED with uncomplicated MTBI (GCS = 15; ground-level falls = 72.4%). Data were collected retrospectively from hospital records, including clinical signs of injury, preexisting health conditions [including preinjury abnormalities on head computed tomography (CT)], and location of follow-up (i.e., home versus other health/rehabilitation facility). A higher odds ratio (OR) indicated a greater likelihood of continued care discharge to another health facility.

Results

Among participants 55–69 years-old, preexisting neurological diseases (OR = 2.92), mental/behavioral health conditions (OR = 3.05), and CT abnormalities (OR = 3.02) were associated with greater odds of continued care. Among participants 70+ years-old, preexisting neurological diseases (OR = 2.60) and CT abnormalities (OR = 2.12) were associated with greater odds of continued care. Preexisting circulatory system diseases, loss of consciousness, and amnesia were not associated with greater odds of continued care for either age group.

Conclusions

Among older adults with uncomplicated MTBIs, preexisting health conditions were associated with greater odds of continued care than loss of consciousness or amnesia. These findings reveal the importance of preexisting health conditions in the acute clinical management of MTBI in older adults, in that preexisting conditions have greater associations with care planning than clinical signs of injury.

A global database of Holocene paleotemperature records

A comprehensive database of paleoclimate records is needed to place recent warming into the longer-term context of natural climate variability. We present a global compilation of quality-controlled, published, temperature-sensitive proxy records extending back 12,000 years through the Holocene. Data were compiled from 679 sites where time series cover at least 4000 years, are resolved at sub-millennial scale (median spacing of 400 years or finer) and have at least one age control point every 3000 years, with cut-off values slackened in data-sparse regions. The data derive from lake sediment (51%), marine sediment (31%), peat (11%), glacier ice (3%), and other natural archives. The database contains 1319 records, including 157 from the Southern Hemisphere. The multi-proxy database comprises paleotemperature time series based on ecological assemblages, as well as biophysical and geochemical indicators that reflect mean annual or seasonal temperatures, as encoded in the database. This database can be used to reconstruct the spatiotemporal evolution of Holocene temperature at global to regional scales, and is publicly available in Linked Paleo Data (LiPD) format.