Predictors and Time‐Based Hospital Mortality in Patients with Isolated and Polytrauma Brain Injuries

El‐Menyar, Ayman; Consunji, Rafael; Abdelrahman, Husham; Latifi, Rifat; Wahlen, Bianca M.; Al-Thani, Hassan

doi:10.1007/s00268-017-4310-2

Cited by 13 publications

(13 citation statements)

References 38 publications

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“…At the end of follow - up, about 103 patients died and 235 patients were censored, thereby resulting in a cumulative incidence of death of 30.47% after 80 days of follow-up and a mortality rate of 25.3 per 1000 person-days. These findings are similar to the results obtained by a study conducted in Malawi (30.9%) and Qatar (27%) [24] , [27] , but lower compared with a study conducted in Turkey University Hospital (50%) [28] and higher compared with other studies conducted in Ethiopia (2.11% to 21.2%) 21. , 29.…”

Section: Discussionsupporting

confidence: 89%

Survival status and predictors of mortality among traumatic brain injury patients in an Ethiopian hospital: A retrospective cohort study

Amare

Tesfaye

Ali

et al. 2021

African Journal of Emergency Medicine

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Introduction Traumatic brain injury is a major global public health problem causing substantial mortality among the adult population. Hence, this study aimed to determine the predictors of mortality among adult traumatic brain injury patients in Felegehiwot Comprehensive Specialized Hospital in Northwest Ethiopia during 2020. Methods A retrospective cohort study was conducted at Felegehiwot Comprehensive Specialized Hospital using anonymized patient data obtained from chart review. Descriptive statistics were used to summarise the patient characteristics. The Kaplan–Meier survival curve and log-rank test were used to test for differences in survival status among groups. The Cox proportional hazards regression model was used at the 5% level of significance to determine the net effect of each explanatory variable on time to death. Results In total, 338 patients aged ≥15 years and diagnosed with traumatic brain injury were included in the analysis. Among these patients, 103 (30.45%) died, giving a crude death rate of 25.53 per 1000 (95% CI: 21.05–30.98) person-days of follow-up. The overall median survival time was 44 days. The independent predictors of mortality after diagnosis of traumatic brain injury were admission Glasgow coma scale score ≤ 8 (adjusted hazard ratio (AHR): 4.85; 95% confidence interval (CI): 1.73–13.62), bilateral non-reactive pupils at admission (AHR: 2.00 (95% CI: 1.10–3.71), elevated systolic blood pressure at admission (AHR: 0.31; 95% CI:0.11–0.86), elevated diastolic blood pressure at admission (AHR: 3.54; 95% CI: 1.33–9.43), and haematoma evacuation (AHR: 0.42; 95% CI: 0.16–0.90). Discussion The Survival status of traumatic brain injury patients was relatively low in this study. Glasgow coma scale score, bilateral non-reactive pupils, and elevated blood pressure were significant predictors of mortality. Further prospective follow-up studies that include residence and occupation are recommended.

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Section: Discussionsupporting

confidence: 89%

Survival status and predictors of mortality among traumatic brain injury patients in an Ethiopian hospital: A retrospective cohort study

Amare

Tesfaye

Ali

et al. 2021

African Journal of Emergency Medicine

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“…The presence of polytrauma has been previously associated with more severe mechanisms of injury, higher initial injury severity score, 25 and mortality. 26 In our study, polytrauma was associated with a more severe GCS at presentation and higher Marshall scores, likely due to association with injuries of greater severity, higher force, and/or greater velocity. We observed a significantly higher incidence of polytrauma in MVA patients (68 vs. 29%), consistent with literature reporting an association of MVAs with polytrauma, 26,27 AA, African-American; CT, computed tomography; GCS, Glasgow Coma Scale; SD, standard deviation; TBI, traumatic brain injury.…”

Section: Polytrauma Confers Greater Risk For Disability After Tbimentioning

confidence: 48%

Polytrauma Is Associated with Increased Three- and Six-Month Disability after Traumatic Brain Injury: A TRACK-TBI Pilot Study

Yue

Satris

Ore

et al. 2020

Neurotrauma Reports

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Polytrauma and traumatic brain injury (TBI) frequently co-occur and outcomes are routinely measured by the Glasgow Outcome Scale-Extended (GOSE). Polytrauma may confound GOSE measurement of TBI-specific outcomes. Adult patients with TBI from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study had presented to a Level 1 trauma center after injury, received head computed tomography (CT) within 24 h, and completed the GOSE at 3 months and 6 months post-injury. Polytrauma was defined as an Abbreviated Injury Score (AIS) ‡3 in any extracranial region. Univariate regressions were performed using known GOSE clinical cutoffs. Multi-variable regressions were performed for the 3-and 6-month GOSE, controlling for known demographic and injury predictors. Of 361 subjects (age 44.9 -18.9 years, 69.8% male), 69 (19.1%) suffered polytrauma. By Glasgow Coma Scale (GCS) assessment, 80.1% had mild, 5.8% moderate, and 14.1% severe TBI. On univariate logistic regression, polytrauma was associated with increased odds of moderate disability or worse (GOSE £6; 3 month odds ratio [OR] = 2.57 [95% confidence interval (CI): 1.50-4.41; 6 month OR = 1.70 [95% CI: 1.01-2.88]) and death/severe disability (GOSE £4; 3 month OR = 3.80 [95% CI: 2.03-7.11]; 6 month OR = 3.33 [95% CI: 1.71-6.46]). Compared with patients with isolated TBI, more polytrauma patients experienced a decline in GOSE from 3 to 6 months (37.7 vs. 24.7%), and fewer improved (11.6 vs. 22.6%). Polytrauma was associated with greater univariate ordinal odds for poorer GOSE (3 month OR = 2.79 [95% CI: 1.73-4.49]; 6 month OR = 1.73 [95% CI: 1.07-2.79]), which was conserved on multivariable ordinal regression (3 month OR = 3.05 [95% CI: 1.76-5.26]; 6 month OR = 2.04 [95% CI: 1.18-3.42]). Patients with TBI with polytrauma are at greater risk for 3-and 6-month disability compared with those with isolated TBI. Methodological improvements in assessing TBI-specific disability, versus disability attributable to all systemic injuries, will generate better TBI outcomes assessment tools.

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“…Penelitian di Athena menunjukkan tingkat mortalitas pada pasien perempuan (34,95%) lebih tinggi dibandingkan pasien laki-laki (24,83%). Berdasarkan mekanisme cedera, penyebab terbanyak cedera adalah kecelakaan kendaraan bermotor dengan tingkat mortalitas paling tinggi yaitu sebesar 28,31% (El-Menyar et al, 2018). Dampak kerugian ekonomi akibat cidera khususnya akibat kecelakaan lalu lintas Di Indonesia diperkirakan sebesar 2,9% pendapatan domestik bruto (PDB).…”

Section: Pendahuluanunclassified

Hubungan Skor Awal GCS dengan Outcome pada Pasien Cedera Kepala

Zuhroidah

Toha

Sujarwadi

et al. 2021

JI-KES

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Cedera kepala adalah gangguan struktur dan fungsi otak yang diakibatkan oleh gaya mekanik dari luar tubuh, ada beberapa faktor prognosis yang berhubungan dengan outcome pasien cedera kepala meliputi jenis kelamin, usia, skor awal GCS, reflek pupil, gambaran CT scan, tanda vital dan hasil laboratorium. Penelitian ini bertujuan untuk menganalisis hubungan antara skor awal GCS dengan outcome pada pasien cedera kepala di Rumah Sakit X di Pasuruan. Penelitian ini menggunakan metode observasional analitik dengan pendekatan desain cross sectional. Pengukuran variabel independen berupa tingkat kesadaran (GCS) dan variebel dependen berupa nilai Trauma and Injury Severity Score (TRISS) dilakukan secara simultan pada satu saat dan dinilai hanya satu kali saja. Populasi yang digunakan adalah semua pasien cedera kepala di IGD Rumah Sakit X di Pasuruan. Besar sampel yang digunakan adalah 53 responden dengan teknik concecutive sampling. Data diuji menggunakan correlational Kendall Tau dengan level signifikan < 0.005. Hasil uji menunjukkan adanya hubungan antara Skor Awal GCS dengan Outcome pada Pasien Cedera Kepala dengan nilai p =0.00 < 0.05,nilai korelasi 0.402 yang berarti terdapat hubungan sangat erat dan bersifat positif, setiap terjadi penurunan GCS maka nilai TRISS juga akan menurun. Hasil penelitian ini memperkuat indikasi tentang pentingnya penanganan yang tepat dan segera pada penderita yang mengalami penurunan GCS diawal kejadian trauma.

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Predictors and Time‐Based Hospital Mortality in Patients with Isolated and Polytrauma Brain Injuries

Cited by 13 publications

References 38 publications

Survival status and predictors of mortality among traumatic brain injury patients in an Ethiopian hospital: A retrospective cohort study

Survival status and predictors of mortality among traumatic brain injury patients in an Ethiopian hospital: A retrospective cohort study

Polytrauma Is Associated with Increased Three- and Six-Month Disability after Traumatic Brain Injury: A TRACK-TBI Pilot Study

Hubungan Skor Awal GCS dengan Outcome pada Pasien Cedera Kepala

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