Determinants of caregiver burden in male patients with epilepsy following penetrating traumatic brain injury

2021 ◽  
Vol 116 ◽  
pp. 107768
Author(s):  
Roxana Jabbarinejad ◽  
Shira Cohen-Zimerman ◽  
Amy K. Wagner ◽  
Jordan Grafman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Caregiver Burden ◽  
Male Patients ◽  
Patients With Epilepsy ◽  
Penetrating Traumatic Brain Injury

Severe Traumatic Brain Injury

2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Severe Traumatic Brain Injury ◽  
Neurocritical Care ◽  
Secondary Brain Injury ◽  
Brain Oxygenation ◽  
Barbiturate Coma ◽  
Blast Traumatic Brain Injury ◽  
Penetrating Traumatic Brain Injury

Traumatic brain injury remains a leading cause of death and disability worldwide. Patients with severe traumatic brain injury are best treated with a multidisciplinary, evidence-based, protocol-directed approach, which has been shown to decrease mortality and improve functional outcomes. Therapy is directed at the prevention of secondary brain injury through optimizing cerebral blood flow and the delivery of metabolic fuel (ie, oxygen and glucose). This is accomplished through the measurement and treatment of elevated intracranial pressure (ICP), the strict avoidance of hypotension and hypoxemia, and in some instances, surgical management. The treatment of elevated ICP is approached in a protocolized, tiered manner, with escalation of care occurring in the setting of refractory intracranial hypertension, culminating in either decompressive surgery or barbiturate coma. With such an approach, the rates of mortality secondary to traumatic brain injury are declining despite an increasing incidence of traumatic brain injury. This review contains 3 figures, 5 tables and 69 reference Key Words: blast traumatic brain injury, brain oxygenation, cerebral perfusion pressure, decompressive craniectomy, hyperosmolar therapy, intracranial pressure, neurocritical care, penetrating traumatic brain injury, severe traumatic brain injury

scholarly journals Perceived health, caregiver burden, and quality of life in women partners providing care to Veterans with traumatic brain injury

2016 ◽  
Vol 53 (6) ◽  
pp. 681-692 ◽  
Author(s):  
Karen L. Saban ◽  
Joan M. Griffin ◽  
Amanda Urban ◽  
Marissa A. Janusek ◽  
Theresa Louise-Bender Pape ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Caregiver Burden ◽  
Perceived Health ◽  
Women Partners

Characterization of a Novel Rat Model of Penetrating Traumatic Brain Injury

2012 ◽  
Vol 29 (6) ◽  
pp. 1219-1232 ◽  
Author(s):  
Stefan Plantman ◽  
Kian Chye Ng ◽  
Jia Lu ◽  
Johan Davidsson ◽  
Mårten Risling
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rat Model ◽  
Penetrating Traumatic Brain Injury

scholarly journals Prognostic performance of computerized tomography scoring systems in civilian penetrating traumatic brain injury: an observational study

2019 ◽  
Vol 161 (12) ◽  
pp. 2467-2478 ◽  
Author(s):  
Matias Lindfors ◽  
Caroline Lindblad ◽  
David W. Nelson ◽  
Bo-Michael Bellander ◽  
Jari Siironen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Computerized Tomography ◽  
Outcome Prediction ◽  
Unfavorable Outcome ◽  
Receiver Operating Curve ◽  
Excellent Performance ◽  
Head Ct ◽  
Severity Scores ◽  
Penetrating Traumatic Brain Injury

Abstract Background The prognosis of penetrating traumatic brain injury (pTBI) is poor yet highly variable. Current computerized tomography (CT) severity scores are commonly not used for pTBI prognostication but may provide important clinical information in these cohorts. Methods All consecutive pTBI patients from two large neurotrauma databases (Helsinki 1999–2015, Stockholm 2005–2014) were included. Outcome measures were 6-month mortality and unfavorable outcome (Glasgow Outcome Scale 1–3). Admission head CT scans were assessed according to the following: Marshall CT classification, Rotterdam CT score, Stockholm CT score, and Helsinki CT score. The discrimination (area under the receiver operating curve, AUC) and explanatory variance (pseudo-R2) of the CT scores were assessed individually and in addition to a base model including age, motor response, and pupil responsiveness. Results Altogether, 75 patients were included. Overall 6-month mortality and unfavorable outcome were 45% and 61% for all patients, and 31% and 51% for actively treated patients. The CT scores’ AUCs and pseudo-R2s varied between 0.77–0.90 and 0.35–0.60 for mortality prediction and between 0.85–0.89 and 0.50–0.57 for unfavorable outcome prediction. The base model showed excellent performance for mortality (AUC 0.94, pseudo-R2 0.71) and unfavorable outcome (AUC 0.89, pseudo-R2 0.53) prediction. None of the CT scores increased the base model’s AUC (p > 0.05) yet increased its pseudo-R2 (0.09–0.15) for unfavorable outcome prediction. Conclusion Existing head CT scores demonstrate good-to-excellent performance in 6-month outcome prediction in pTBI patients. However, they do not add independent information to known outcome predictors, indicating that a unique score capturing the intracranial severity in pTBI may be warranted.

scholarly journals Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury

2020 ◽  
Vol 17 (17) ◽  
pp. 6386
Author(s):  
Kirsten Lieshout ◽  
Joanne Oates ◽  
Anne Baker ◽  
Carolyn A. Unsworth ◽  
Ian D. Cameron ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Caregiver Burden ◽  
Severe Traumatic Brain Injury ◽  
Informal Caregivers ◽  
Family Care ◽  
Care Recipient ◽  
Chi Square ◽  
Cross Sectional ◽  
Reported Data

This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role.

scholarly journals Hospital admission and readmission among homeless patients with neurologic disease: Retraction and replacement

Neurology ◽  
2019 ◽  
Vol 92 (24) ◽  
pp. e2822-e2831 ◽  
Author(s):  
Nicole Rosendale ◽  
Elan L. Guterman ◽  
John P. Betjemann ◽  
S. Andrew Josephson ◽  
Vanja C. Douglas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Primary Outcome ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Hospital Level ◽  
Cross Sectional ◽  
Using Data ◽  
Patients With Epilepsy ◽  
Inpatient Database

ObjectiveTo characterize the most common neurologic diagnoses leading to hospitalization for homeless compared to housed individuals and to assess whether homelessness is an independent risk factor for 30-day readmission after an admission for a neurologic illness.MethodsWe performed a retrospective serial cross-sectional study using data from the Healthcare Cost and Utilization Project California State Inpatient Database from 2006 to 2011. Adult patients with a primary neurologic discharge diagnosis were included. The primary outcome was 30-day readmission. We used multilevel logistic regression to examine the association between homelessness and readmission after adjustment for patient factors.ResultsWe identified 1,082,347 patients with a neurologic primary diagnosis. The rate of homelessness was 0.37%. The most common indications for hospitalization among homeless patients were seizure and traumatic brain injury, both of which were more common in the homeless compared to housed population (19.3% vs 8.1% and 31.9% vs 9.2%, respectively, p < 0.001). A multilevel mixed-effects model controlling for patient age, sex, race, insurance type, comorbid conditions, and clustering on the hospital level found that homelessness was associated with increased 30-day readmission (odds ratio 1.5, 95% confidence interval 1.4–1.6, p < 0.001). This association persisted after this analysis was repeated within specific diagnoses (patients with epilepsy, trauma, encephalopathy, and neuromuscular disease).ConclusionThe most common neurologic reasons for admission among homeless patients are seizure and traumatic brain injury; these patients are at high risk for readmission. Future interventions should target the drivers of readmissions in this vulnerable population.

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