Traumatic brain injury and palliative care: a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey

Abstract

Traumatic brain injury (TBI), which is seen more in young adults, affects both patients and their families. The need for palliative care in TBI and the limits of the care requirement are not clear. The aim of this study was to investigate the length of stay in the palliative care center (PCC), Turkey, the status of patients at discharge, and the need for palliative care in patients with TBI. The medical records of 49 patients with TBI receiving palliative care in PCC during 2013–2016 were retrospectively collected, including age and gender of patients, the length of stay in PCC, the cause of TBI, diagnosis, Glasgow Coma Scale score, Glasgow Outcome Scale score, Karnofsky Performance Status score, mobilization status, nutrition route (oral, percutaneous endoscopic gastrostomy), pressure ulcers, and discharge status. These patients were aged 45.4 ± 20.2 years. The median length of stay in the PCC was 34.0 days. These included TBI patients had a Glasgow Coma Scale score ≤ 8, were not mobilized, received tracheostomy and percutaneous endoscopic gastrostomy nutrition, and had pressure ulcers. No difference was found between those who were discharged to their home or other places (rehabilitation centre, intensive care unit and death) in respect of mobilization, percutaneous endoscopic gastrostomy, tracheostomy and pressure ulcers. TBI patients who were followed up in PCC were determined to be relatively young patients (45.4 ± 20.2 years) with mobilization and nutrition problems and pressure ulcer formation. As TBI patients have complex health conditions that require palliative care from the time of admittance to intensive care unit, provision of palliative care services should be integrated with clinical applications.

Living with the patient who has persistence vegetative state: a qualitative study

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Management and Challenges of Severe Traumatic Brain Injury

“…Severe TBI is associated with high morbidity and mortality and is one of the most common diagnoses prompting specialist palliative care consultation in the ICU. 160 Patients with TBI have unclear quality of life in the context of complex and expensive needs, requiring specialized care, such as assisted mobilization, percutaneous endoscopic gastrostomy or tracheostomy placement, pressure ulcers prevention, neurocognitive rehabilitation, and other care, 161 and thus early and continued determination and clarification of goals of care should occur. A persistent issue in end-of-life TBI care is the timing of withdrawal of life support and the deeming of an injury "nonsurvivable."…”

Effect of Regular Aerobic Exercise on Daily Life Activities and Moods of the Patients with Traumatic Brain Injury: Two Cases

“…TBI is the most important cause of mortality and long-term disability in young people in developed countries. Its global incidence presents a sharp increase due to the increased use of motor vehicles in developing and underdeveloped countries (5,6). TBI affects not only the patient but also the family at the same time, leading to a decrease in the quality of life of all individuals involved.…”

“…Care needs, duration of the treatments, and degree of caregiver burnout syndrome increase as the severity of disability in a patient with TBI increases. It is necessary to diagnose the problems early and structure a complete treatment regimen for the physical, mental, and psychosocial problems of these patients (6,9).…”