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Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study.
Yue, John K; Etemad, Leila L; Elguindy, Mahmoud M; van Essen, Thomas A; Belton, Patrick J; Nelson, Lindsay D; McCrea, Michael A; Vreeburg, Rick J G; Gotthardt, Christine J; Tracey, Joye X; Coskun, Bukre C; Krishnan, Nishanth; Halabi, Cathra; Eagle, Shawn R; Korley, Frederick K; Robertson, Claudia S; Duhaime, Ann-Christine; Satris, Gabriela G; Tarapore, Phiroz E; Huang, Michael C; Madhok, Debbie Y; Giacino, Joseph T; Mukherjee, Pratik; Yuh, Esther L; Valadka, Alex B; Puccio, Ava M; Okonkwo, David O; Sun, Xiaoying; Jain, Sonia; Manley, Geoffrey T; DiGiorgio, Anthony M; Badjatia, Neeraj; Barber, Jason; Bodien, Yelena G; Fabian, Brian; Ferguson, Adam R; Foreman, Brandon; Gardner, Raquel C; Gopinath, Shankar; Grandhi, Ramesh; Russell Huie, J; Dirk Keene, C; Lingsma, Hester F; MacDonald, Christine L; Markowitz, Amy J; Merchant, Randall; Ngwenya, Laura B; Rodgers, Richard B; Schneider, Andrea L C; Schnyer, David M.
Afiliación
  • Yue JK; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Etemad LL; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Elguindy MM; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • van Essen TA; Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands.
  • Belton PJ; Neurological Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Nelson LD; Neurology and Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • McCrea MA; Neurology and Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Vreeburg RJG; Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands.
  • Gotthardt CJ; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Tracey JX; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Coskun BC; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Krishnan N; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Halabi C; Neurology, University of California San Francisco, San Francisco, California, USA.
  • Eagle SR; Neurological Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA.
  • Korley FK; Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Robertson CS; Neurological Surgery, Baylor College of Medicine, Houston, Texas, USA.
  • Duhaime AC; Neurological Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Satris GG; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Tarapore PE; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Huang MC; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Madhok DY; Emergency Medicine, University of California San Francisco, San Francisco, California, USA.
  • Giacino JT; Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Mukherjee P; Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
  • Yuh EL; Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
  • Valadka AB; Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Puccio AM; Neurological Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA.
  • Okonkwo DO; Neurological Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA.
  • Sun X; Biostatistics Research Center, Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, California, USA.
  • Jain S; Biostatistics Research Center, Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, California, USA.
  • Manley GT; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • DiGiorgio AM; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Badjatia N; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Barber J; Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands.
  • Bodien YG; Neurological Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Fabian B; Neurology and Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Ferguson AR; Neurology, University of California San Francisco, San Francisco, California, USA.
  • Foreman B; Neurological Surgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA.
  • Gardner RC; Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Gopinath S; Neurological Surgery, Baylor College of Medicine, Houston, Texas, USA.
  • Grandhi R; Neurological Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Russell Huie J; Emergency Medicine, University of California San Francisco, San Francisco, California, USA.
  • Dirk Keene C; Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Lingsma HF; Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
  • MacDonald CL; Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  • Markowitz AJ; Biostatistics Research Center, Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, California, USA.
  • Merchant R; Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
  • Ngwenya LB; Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands.
  • Rodgers RB; Neurological Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
  • Schneider ALC; Neurology and Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  • Schnyer DM; Neurology, University of California San Francisco, San Francisco, California, USA.
Trauma Surg Acute Care Open ; 9(1): e001501, 2024.
Article en En | MEDLINE | ID: mdl-39081460
ABSTRACT

Objectives:

An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.

Methods:

Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury.

Results:

Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI 17.2%, no prior TBI 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.

Conclusions:

After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed. Level of evidence IV. Trial registration number NCT02119182.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Trauma Surg Acute Care Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Trauma Surg Acute Care Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos