Predictors of mortality in patients with isolated severe traumatic brain injury

Strnad, Matej; Lesjak, Vesna Borovnik; Vujanović, Vitka; Križmarić, Miljenko

doi:10.1007/s00508-016-0974-0

Cited by 14 publications

(16 citation statements)

References 18 publications

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“…Severe traumatic brain injury (TBI) is one of the most common causes of death in young adults in the industrialized nations [28,29,30]. Secondary injury which is the result of the initiation of pathophysiological signaling pathways radically exacerbates the principal injury triggered by the trauma and is accountable for almost a third of all deaths associated with traumatic brain injury [31,32,33].…”

Section: Discussionmentioning

confidence: 99%

Reduced Neuroinflammation and Improved Functional Recovery after Traumatic Brain Injury by Prophylactic Diet Supplementation in Mice

Zhu

Taheri

et al. 2019

Nutrients

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Currently, there are no approved therapeutic drugs for the treatment of traumatic brain injury (TBI), and new targets and approaches are needed to provide relief from the long-term effects of TBI. Recent studies suggest that nutrition plays a critical role in improving the outcome from TBI in both civilians and military personnel. We have previously shown that GrandFusion® (GF) diets improved recovery from cerebral ischemia and enhanced physical activity and endurance in rodent models. We, therefore, sought to determine the impact of a prophylactic diet enriched in fruits and vegetables on recovery from TBI in the controlled cortical impact rodent model. Results demonstrated that mice fed the diets had improved neuromotor function, reduced lesion volume, increased neuronal density in the hippocampus and reduced inflammation. As previously shown, TBI increases cathepsin B as part of the inflammasome complex resulting in elevated inflammatory markers like interleukin-1β (IL-1β). Consumption of the GF diets attenuated the increase in cathepsin B levels and prevented the increase in the proapoptotic factor Bax following TBI. These data suggest that prior consumption of diets enriched in fruits and vegetables either naturally or through powdered form can provide protection from the detrimental effects of TBI.

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Section: Discussionmentioning

confidence: 99%

Reduced Neuroinflammation and Improved Functional Recovery after Traumatic Brain Injury by Prophylactic Diet Supplementation in Mice

Zhu

Taheri

et al. 2019

Nutrients

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“…The regular assessment of the risk of deterioration through EWS is a standard procedure in multiple clinical context the use of which is more than contrasted [14,15,28] and which can help to detect patients with TBI and a high risk [49,50]. Determining which patients may be subsidiaries of advanced procedures and rapid transportation to a useful center must be a priority for the EMS [51].…”

Section: Early Warning Scores (Ews) and Prehospital Tbimentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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Traumatic brain injuries are complex situations in which the emergency medical services must quickly determine the risk of deterioration using minimal diagnostic methods. The aim of this study is to analyze whether the use of early warning scores can help with decision-making in these dynamic situations by determining the patients who need the intensive care unit. A prospective, multicentric cohort study without intervention was carried out on traumatic brain injury patients aged over 18 given advanced life support and taken to the hospital. Our study included a total of 209 cases. The total number of intensive-care unit admissions was 50 cases (23.9%). Of the scores analyzed, the National Early Warning Score2 was the best result presented with an area under the curve of 0.888 (0.81–0.94; p < 0.001) and an odds ratio of 25.4 (95% confidence interval (CI):11.2–57.5). The use of early warning scores (and specifically National Early Warning Score2) can help the emergency medical services to differentiate traumatic brain injury patients with a high risk of deterioration. The emergency medical services should use the early warning scores routinely in all cases for the early detection of high-risk situations.

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“…In this study, age, gender, co-morbidity, BAC, GCS, and ISS were used as covariates for the propensity score-matching. In addition to being comorbidities, GCS and ISS have been well recognized as independent risk factors for mortality due to TBI [24,25,26,27]; gender and BAC also may have a significant effect on the mortality of patients who sustained TBI [28,29]. In a retrospective study of 1627 TBI patients, female patients had a significantly higher mortality (3.4% vs. 1.6%, p = 0.048) [30].…”

Section: Discussionmentioning

confidence: 99%

Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis

Rau

Kuo

et al. 2016

IJERPH

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Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score < −4; n = 849), medium-risk (−4 ≤ OSTA score ≤ −1; n = 1647), or low-risk (OSTA score > −1; n = 5359). Two-sided Pearson’s chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39–4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19–2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age may contribute to the significantly higher mortality associated with a lower OSTA score. Conclusions: Older age may be able to explain the association of lower OSTA score and higher mortality rates in patients with isolated moderate and severe TBI.

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Predictors of mortality in patients with isolated severe traumatic brain injury

Abstract: In prehospital intubated patients with isolated severe TBI only ISS and mydriasis were found to be independent predictors of in-hospital mortality.

Cited by 14 publications

References 18 publications

Reduced Neuroinflammation and Improved Functional Recovery after Traumatic Brain Injury by Prophylactic Diet Supplementation in Mice

Reduced Neuroinflammation and Improved Functional Recovery after Traumatic Brain Injury by Prophylactic Diet Supplementation in Mice

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis

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