• Ernest Jan Bobeff, Konrad Stawiski, Patrycja Alicja Stanisławska, Bartłomiej Józef Posmyk, Karol Wiśniewski, Maciej Bryl, Michał Mateusz Piotrowski, Jan Fortuniak, and Dariusz Jan Jaskólski.
• Department of Neurosurgery and Neuro-oncology, Medical University of Lodz, Lodz, Poland. Electronic address: ernestbobeff@gmail.com.
• World Neurosurg. 2022 May 1; 161: e464-e472.

BackgroundTraumatic brain injury (TBI) poses a particular health risk for the elderly. The recently developed elderly TBI (eTBI) score combines the prognostic information of the risk factors characteristic of the geriatric population. We aimed to determine its validity and reliability on an independent sample.MethodsWe present a retrospective analysis of 506 consecutive patients after TBI aged ≥65 years. The previously described nomogram and the eTBI score were used. The primary outcome measure was mortality or vegetative state at 30 days after hospital admission.ResultsMortality or vegetative state rate was 21.3%. The nomogram and eTBI Score showed similar predictive performance with accuracy of 83.8% (95% confidence interval 80.2%-87%) and 84.4% (95% confidence interval 80.8%-87.6%), respectively. On the basis of the Youden index and C4.5 algorithm, we divided patients according to the 3-tier pattern into low-, high-, and medium-risk groups. The outcome prediction in the first 2 groups was correct in 93.1% (survival in the low-risk group) and 94.4% (mortality in the high-risk group). Patients included in the medium-risk group usually required surgical treatment (85.3%) and were characterized by increased mortality or vegetative state (55%). Among patients with eTBI ≥5 (n = 221), there was no difference in outcome between those treated conservatively and surgically.ConclusionsThis is the first study confirming the validity of the eTBI Score and its close association with outcome of geriatric population after TBI. The novel 3-tier risk stratification scheme was applicable to both conservatively and surgically treated patients.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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