Long-term risk of dementia among people with traumatic brain injury in Denmark: a population-based observational cohort study

AimTo determine if survival and hospital resource usage differ following traumatic brain injury (TBI) compared with head injury without neurological injury(HI).MethodsThis retrospective population-based cohort study included all 25 319 patients admitted to a Scottish NHS hospital from 1997–2015 with TBI. Participants were identified using previously validated ICD-10 based definitions. For comparison, all 194 049 HI cases were identified. Our main outcome measures were hazards of all-cause mortality after TBI, compared with HI, over 18 years follow-up period; and odds of mortality at one month post-injury. Number of days spent as inpatients and number of outpatient attendances per surviving month post-injury were used as measures of resource utilisation.ResultsThe adjusted odds ratio for mortality in the first month post-injury for TBI was 7.12 (95% confidence interval [CI] 6.73–7.52; p<0.001). For the remaining 18 year study period, the hazards of morality after TBI were 0.93 (CI 0.90–0.96; p<0.001). TBI was associated with 2.15 (CI 2.10–2.20; p<0.001) more days spent as inpatient and 1.09 times more outpatient attendances (CI 1.07–1.11; p<0.001) than HI.ConclusionsAlthough initial mortality following TBI is high, survivors of the first month can achieve comparable long-term survival to HI. However this is associated with increased utilisation of hospital services in the TBI group.

Download Full-text

Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study

The Lancet ◽

10.1016/s0140-6736(09)60214-2 ◽

2009 ◽

Vol 373 (9669) ◽

pp. 1105-1110 ◽

Cited By ~ 183

Author(s):

Jakob Christensen ◽

Marianne G Pedersen ◽

Carsten B Pedersen ◽

Per Sidenius ◽

Jørn Olsen ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Young Adults ◽

Cohort Study ◽

Brain Injury ◽

Population Based ◽

Children And Young Adults

Download Full-text

Faculty Opinions recommendation of Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1157052.617142 ◽

2009 ◽

Author(s):

Donald Marion

Keyword(s):

Traumatic Brain Injury ◽

Young Adults ◽

Cohort Study ◽

Brain Injury ◽

Population Based ◽

Children And Young Adults

Download Full-text

Prospective observational cohort study on epidemiology, treatment and outcome of patients with traumatic brain injury (TBI) in German BG hospitals

BMJ Open ◽

10.1136/bmjopen-2020-045771 ◽

2021 ◽

Vol 11 (6) ◽

pp. e045771

Author(s):

Peter Schwenkreis ◽

Andreas Gonschorek ◽

Florian Berg ◽

Ullrich Meier ◽

Witold Rogge ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Cohort Study ◽

Brain Injury ◽

Large Scale ◽

Telephone Interview ◽

Observational Cohort Study ◽

X Rays ◽

Mild Tbi ◽

Initial Care ◽

Observational Cohort

ObjectivesSince 2000/2001, no large-scale prospective studies addressing traumatic brain injury (TBI) epidemiology in Germany have been published. Our aim was to look for a possible shift in TBI epidemiology described in other European countries, to look for possible changes in TBI management and to identify predictors of 1-year outcome especially in patients with mild TBI.DesignObservational cohort study.SettingAll patients suffering from a TBI of any degree between 1 October 2014 and 30 September 2015, and who arrived in one of the seven participating BG hospitals within 24 hours after trauma, were included.ParticipantsIn total, 3514 patients were included.Outcome measuresInitial care, acute hospital care and rehabilitation were documented using standardised documentation forms. A standardised telephone interview was conducted 3 and 12 months after TBI in order to obtain information on outcome.ResultsPeaks were identified in males in the early 20s and mid-50s, and in both sexes in the late 70s, with 25% of all patients aged 75 or older. A fall was the most frequent cause of TBI, followed by traffic accidents (especially bicyclists). The number of head CT scans increased, and the number of conventional X-rays of the skull decreased compared with 2000/2001. Besides, more patients were offered rehabilitation than before. Though most TBI were classified as mild, one-third of the patients participating in the telephone interview after 12 months still reported troubles attributed to TBI. Negative predictors in mild TBI were female gender, intracranial bleeding and Glasgow Coma Scale (GCS) 13/14.ConclusionThe observed epidemiologic shift in TBI (ie, elderly patients, more falls, more bicyclists) calls for targeted preventive measures. The heterogeneity behind the diagnosis ‘mild TBI’ emphasises the need for defining subgroups not only based on GCS.

Download Full-text

Clinical Impact of Hemorrhagic Lesion Progression Following Moderate-to-Severe Traumatic Brain Injury: An Observational Cohort Study

10.21203/rs.3.rs-570495/v1 ◽

2021 ◽

Author(s):

Alexander Fletcher-Sandersjöö ◽

Charles Tatter ◽

Jonathan Tjerkaski ◽

Jiri Bartek ◽

Marc Maegele ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Regression Analysis ◽

Cohort Study ◽

Brain Injury ◽

Ct Scan ◽

Intracranial Hemorrhage ◽

Observational Cohort Study ◽

Traumatic Intracranial Hemorrhage ◽

Observational Cohort ◽

The Mean

Abstract Background Hemorrhage progression following traumatic brain injury (TBI) is not fully understood, and preventing it would be a potential therapeutic opportunity in TBI management. The aim of this study was to determine how non-operated hemorrhagic lesions progress following TBI, and how this affects outcome. Methods This was a retrospective observational cohort study of adult patients (≥ 15 years) with moderate-to-severe TBI. Hemorrhage volumes were calculated from computed tomography (CT) scans using semi-automated volumetric segmentation. Results In total, 643 patients were included, with a median Glasgow Coma Scale of 7. Contusions were the most common form of traumatic intracranial hemorrhage. The mean total lesion volume on the first CT scan was 4.29 ml, and the mean lesion progression volume (LPV), i.e. the increase in volume from first CT scan until the lesion had stopped progressing, was 3.85 ml. Contusions showed a significantly larger LPV than SDH and EDH (p < 0.001). The median lesion progression time (LPT), i.e. the time from injury until all lesions had stopped progressing, was 5.98 hours, with contusions progressing for a longer time than tSAH, SDH and EDH (p < 0.001). Hemorrhage progression also slowed exponentially over time, with almost no further expansion occurring 24 hours after trauma. In multivariable regression analysis, LPV was independently associated with 12-month Glasgow Outcome Score after adjusting for known TBI outcome predictors (p < 0.001). Conclusions Contusions were the most common form of traumatic intracranial hemorrhage, and exhibited both a larger LPV and longer LPT than extra-axial hematomas. Regression analysis indicated that LPV was independently related to, and possibly a driver of, unfavorable outcome. Interventions to prevent lesion progression are therefore likely to improve outcome in TBI patients. Moreover, this study suggests a wider window of opportunity to prevent lesion progression than what has previously been suggested.

Download Full-text