Impact of Number of Drugs on Rehabilitation Outcomes in Patients after Traumatic Brain Injury: A Retrospective Cohort Study

PM&R ◽  
2020 ◽  
Author(s):  
Makiko Yamaoka ◽  
Masayuki Chono ◽  
Miki Fukumoto ◽  
Tomomi Watanabe ◽  
Takeshi Fukaya ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Rehabilitation Outcomes

scholarly journals Use of Vasopressors Increases the Risk of Mortality in Severe Traumatic Brain Injury: A Nationwide Retrospective Cohort Study in Japan

2021 ◽  
Author(s):  
Sanae Hosomi ◽  
Tomotaka Sobue ◽  
Tetsuhisa Kitamura ◽  
Atsushi Hirayama ◽  
Hiroshi Ogura ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Cohort Study ◽  
Brain Injury ◽  
Propensity Score ◽  
Hospital Discharge ◽  
Severe Traumatic Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Practices

Abstract BackgroundPharmacological elevation of blood pressure is frequently incorporated in severe traumatic brain injury management algorithms. However, there is limited evidence on prevalent clinical practices regarding resuscitation for severe traumatic brain injury using vasopressors. We conducted a nationwide retrospective cohort study to determine the association between the use of vasopressors and mortality following hospital discharge in patients with severe traumatic brain injury, and to determine whether the use of vasopressors affects emergency department mortality or the occurrence of cognitive dysfunction.MethodsData were collected between January 2004 and December 2018 from the Japanese Trauma Data Bank, which includes data from 272 emergency hospitals in Japan. Adults aged ≥16 years with severe traumatic brain injury, without other major injuries, were examined. A severe traumatic brain injury was defined based on the Abbreviated Injury Scale code and a Glasgow Coma Scale score of 3–8 on admission. Multivariable analysis and propensity score matching were performed. Statistical significance was assessed using 95% confidence intervals (CIs).ResultsIn total, 10 284 patients were eligible for analysis, with 650 patients (6.32%) included in the vasopressor group and 9634 patients (93.68%) included in the non-vasopressor group. The proportion of deaths on hospital discharge was higher in the vasopressor group than in the non-vasopressor group (81.69% [531/650] vs. 40.21% [3,874/9,634]). This finding was confirmed by multivariable logistic regression analysis (adjusted odds ratio [OR], 5.71; 95% CI: 4.56–7.16). Regarding propensity score-matched patients, the proportion of deaths on hospital discharge remained higher in the vasopressor group than in the non-vasopressor group (81.66% [530/649] vs. 50.69% [329/649]) (OR, 4.33; 95% CI: 3.37–5.57). The vasopressor group had a higher emergency department mortality rate than the non-vasopressor group (8.01% [52/649] vs. 2.77% [18/649]) (OR, 3.05; 95% CI: 1.77–5.28). There was no reduction in complications of cognitive disorders in the vasopressor group (5.39% [35/649] vs. 5.55% [36/649]) (OR, 0.97; 95% CI: 0.60–1.57).ConclusionsIn this population, the use of vasopressors for severe traumatic brain injury was associated with higher mortality on hospital discharge. Our results suggest that vasopressors should be avoided in most cases of severe traumatic brain injury.

Comparison of the Incidence and Severity of Traumatic Brain Injury Caused by Electrical Bicycle and Bicycle Accidents—A Retrospective Cohort Study From a Swiss Level I Trauma Center

2019 ◽  
Vol 126 ◽  
pp. e1023-e1034 ◽  
Author(s):  
Dominik Baschera ◽  
Damian Jäger ◽  
Raluca Preda ◽  
Werner J. Z'Graggen ◽  
Andreas Raabe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Trauma Center ◽  
Retrospective Cohort ◽  
Level I

A retrospective cohort study of comorbidity trajectories associated with traumatic brain injury in veterans of the Iraq and Afghanistan wars

Brain Injury ◽  
2016 ◽  
Vol 30 (12) ◽  
pp. 1481-1490 ◽  
Author(s):  
Mary Jo Pugh ◽  
Erin P. Finley ◽  
Chen-Pin Wang ◽  
Laurel A. Copeland ◽  
Carlos A. Jaramillo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

Effect of implementation of a paediatric neurocritical care programme on outcomes after severe traumatic brain injury: a retrospective cohort study

2013 ◽  
Vol 12 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Jose A Pineda ◽  
Jeffrey R Leonard ◽  
Ioanna G Mazotas ◽  
Michael Noetzel ◽  
David D Limbrick ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neurocritical Care ◽  
Care Programme

scholarly journals The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Steven W. Howard ◽  
Zidong Zhang ◽  
Paula Buchanan ◽  
Stephanie L. Bernell ◽  
Christine Williams ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neurocritical Care ◽  
Care Program ◽  
Pediatric Neurocritical Care ◽  
The Cost

Mortality Over Four Decades After Traumatic Brain Injury Rehabilitation: A Retrospective Cohort Study

2009 ◽  
Vol 90 (9) ◽  
pp. 1506-1513 ◽  
Author(s):  
Cynthia L. Harrison-Felix ◽  
Gale G. Whiteneck ◽  
Amitabh Jha ◽  
Michael J. DeVivo ◽  
Flora M. Hammond ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Rehabilitation

scholarly journals Ten-year trends in traumatic brain injury: a retrospective cohort study of California emergency department and hospital revisits and readmissions

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022297 ◽  
Author(s):  
Renee Y Hsia ◽  
Amy J Markowitz ◽  
Feng Lin ◽  
Joanna Guo ◽  
Debbie Y Madhok ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort Study ◽  
Hospital Readmission ◽  
Retrospective Cohort ◽  
Secondary Outcome ◽  
Common Mechanism ◽  
First Year ◽  
Severity Of Injury

ObjectiveTo describe visits and visit rates of adults presenting to emergency departments (EDs) with a diagnosis of traumatic brain injury (TBI). TBI is a major cause of death and disability in the USA; yet, current literature is limited because few studies examine longer-term ED revisits and hospital readmission patterns of TBI patients across a broad spectrum of injury severity, which can help inform potential unmet healthcare needs.DesignWe performed a retrospective cohort study.SettingWe analysed non-public patient-level data from California’s Office of Statewide Health Planning and Development for years 2005 to 2014.ParticipantsWe identified 1.2 million adult patients aged ≥18 years presenting to California EDs and hospitals with an index diagnosis of TBI.Primary and secondary outcome measuresOur main outcomes included revisits, readmissions and mortality over time. We also examined demographics, mechanism and severity of injury and disposition at discharge.ResultsWe found a 57.7% increase in the number of TBI ED visits, representing a 40.5% increase in TBI visit rates over the 10-year period (346–487 per 100 000 residents). During this time, there was also a 33.8% decrease in the proportion of patients admitted to the hospital. Older, publicly insured and black populations had the highest visit rates, and falls were the most common mechanism of injury (45.5% of visits). Of all patients with an index TBI visit, 40.5% of them had a revisit during the first year, with 46.7% of them seeking care at a different hospital from their initial hospital or ED visit. Additionally, of revisits within the first year, 13.4% of them resulted in hospital readmission.ConclusionsThe large proportion of patients with TBI who are discharged directly from the ED, along with the high rates of revisits and readmissions, suggest a role for an established system for follow-up, treatment and care of TBI.

scholarly journals Association between vasopressor use and mortality in patients with severe traumatic brain injury: a nationwide retrospective cohort study in Japan

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Sanae Hosomi ◽  
Tomotaka Sobue ◽  
Tetsuhisa Kitamura ◽  
Atsushi Hirayama ◽  
Hiroshi Ogura ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Vasopressor Use
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