External causes of death after severe traumatic brain injury in a multicentre inception cohort: clinical description and risk factors

Brain Injury ◽  
2019 ◽  
Vol 33 (7) ◽  
pp. 821-829 ◽  
Author(s):  
Thomas M. Gates ◽  
Ian J. Baguley ◽  
Melissa T. Nott ◽  
Grahame K. Simpson
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Causes Of Death ◽  
Inception Cohort ◽  
External Causes Of Death ◽  
Clinical Description ◽  
External Causes

Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution

2017 ◽  
Vol 127 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Pierre Esnault ◽  
Mickaël Cardinale ◽  
Henry Boret ◽  
Erwan D'Aranda ◽  
Ambroise Montcriol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Anticoagulation Therapy ◽  
Spine Injury ◽  
Hemorrhagic Complication ◽  
Injury Incidence ◽  
Severe Tbi ◽  
Systemic Anticoagulation

OBJECTIVEBlunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI.METHODSThe authors conducted a prospective, observational, single-center study including all patients with severe TBI admitted in the trauma center. Diagnosis of BCVI was performed using a 64-channel multidetector CT. Characteristics of the patients, CT scan results, and outcomes were collected. A multivariate logistic regression model was developed to determine the risk factors of BCVI. Patients in whom BCVI was diagnosed were treated with systemic anticoagulation.RESULTSIn total, 228 patients with severe TBI who were treated over a period of 7 years were included. The incidence of BCVI was 9.2%. The main risk factors were as follows: motorcycle crash (OR 8.2, 95% CI 1.9–34.8), fracture involving the carotid canal (OR 11.7, 95% CI 1.7–80.9), cervical spine injury (OR 13.5, 95% CI 3.1–59.4), thoracic trauma (OR 7.3, 95% CI 1.1–51.2), and hepatic lesion (OR 13.3, 95% CI 2.1–84.5). Among survivors, 82% of patients with BCVI received systemic anticoagulation therapy, beginning at a median of Day 1.5. The overall stroke rate was 19%. One patient had an intracranial hemorrhagic complication.CONCLUSIONSBlunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%). The main risk factors are high-velocity lesions and injuries near cervical arteries.

scholarly journals Effect of Pre-Hospital Intubation in Patients with Severe Traumatic Brain Injury on Outcome: A Prospective Cohort Study

2019 ◽  
Vol 8 (4) ◽  
pp. 470 ◽  
Author(s):  
Caroline Choffat ◽  
Cecile Delhumeau ◽  
Nicolas Fournier ◽  
Patrick Schoettker
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Prospective Cohort Study ◽  
Severe Traumatic Brain Injury ◽  
Prospective Cohort ◽  
Injury Severity ◽  
Impaired Consciousness ◽  
Pupil Reaction

Secondary injuries are associated with bad outcomes in the case of severe traumatic brain injury (sTBI). Patients with a Glasgow Coma Scale (GCS) < 9 should undergo pre-hospital intubation (PHI). There is controversy about whether PHI is beneficial. The aim of this study was to estimate the effect of PHI in patients after sTBI. A multicenter, prospective cohort study was performed in Switzerland, including 832 adults with sTBI. Outcomes were death and impaired consciousness at 14 days. Associations between risk factors and outcomes were assessed with univariate and multivariate Cox models for survival, and univariate and multivariate regression models for impaired consciousness. Potential risk factors were age, GCS on scene, pupil reaction, Injury Severity Score (ISS), PHI, oxygen administration, and type of admission to trauma center. Age, GCS on scene < 9, abnormal pupil reaction and ISS ≥ 25 were associated with mortality. GCS < 9 and ISS ≥ 25 were correlated with impaired consciousness. PHI was overall not associated with short-term mortality and consciousness. However, there was a significative interaction with PHI and major trauma. PHI improves outcome from patients with sTBI and an ISS ≥ 25.

scholarly journals Risk factors and novel prognostic score for predicting the 14-day mortality of severe traumatic brain injury patients

2020 ◽  
Vol 11 (3) ◽  
pp. 699
Author(s):  
Nyoman Golden ◽  
Putu Eka Mardhika ◽  
Wayan Niryana ◽  
I Made Sukarya ◽  
I Putu Yuda Prabawa
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Prognostic Score

Pulmonary embolism following severe traumatic brain injury: incidence, risk factors and impact outcome

2017 ◽  
Vol 43 (9) ◽  
pp. 1433-1435 ◽  
Author(s):  
Mabrouk Bahloul ◽  
Hedi Chelly ◽  
Kais Regaieg ◽  
Nessrine Rekik ◽  
Samar Bellil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Pulmonary Embolism ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Injury Incidence ◽  
Incidence Risk ◽  
Impact Outcome
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