scholarly journals Traumatic brain injury may be an independent risk factor for stroke

Neurology ◽  
2013 ◽  
Vol 81 (1) ◽  
pp. 33-39 ◽  
Author(s):  
J. F. Burke ◽  
J. L. Stulc ◽  
L. E. Skolarus ◽  
E. D. Sears ◽  
D. B. Zahuranec ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Independent Risk Factor

scholarly journals Fresh frozen plasma transfusion is an independent risk factor for mortality in traumatic brain injury patients

2011 ◽  
Vol 213 (3) ◽  
pp. S50
Author(s):  
Gerard P. De Castro ◽  
Grant V. Bochicchio ◽  
Ian R. Driscoll ◽  
Deborah M. Stein ◽  
Kelly M. Bochicchio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Independent Risk Factor ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Prognostic value of leukocytosis in pediatric traumatic brain injury

2020 ◽  
pp. 1-11
Author(s):  
Soumya Mukherjee ◽  
Gnanamurthy Sivakumar ◽  
John R. Goodden ◽  
Atul K. Tyagi ◽  
Paul D. Chumas
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Hospital Stay ◽  
Neutrophil Count ◽  
Prognostic Value ◽  
Independent Risk Factor ◽  
Leukocyte Count ◽  
Poor Outcome ◽  
Gcs Score

OBJECTIVEThe purpose of this study was to assess leukocytosis and its prognostic value in pediatric isolated traumatic brain injury (TBI).METHODSTwo hundred one children with isolated TBI admitted to the authors’ institution between June 2006 and June 2018 were prospectively followed and their data retrospectively analyzed. Initial blood leukocyte count (i.e., white cell count [WCC]), Glasgow Coma Scale (GCS) score, CT scans, duration of hospital stay, and Pediatric Cerebral Performance Category Scale (PCPCS) scores were analyzed.RESULTSThe mean age was 4.2 years (range 0.2–16 years). Seventy-four, 70, and 57 patients had severe (GCS score 3–8), moderate (GCS score 9–13), and mild (GCS score 14–15) TBI, respectively, with associated WCC of 20, 15.9, and 10.7 × 109/L and neutrophil counts of 15.6, 11.3, and 6.1 × 109/L, respectively (p < 0.01). Higher WCC and neutrophil counts were demonstrated in patients with increased intracranial mass effect on CT, longer hospital stay, and worse 6-month PCPCS score (p < 0.05). Multivariate regression revealed a cutoff leukocyte count of 16.1 × 109/L, neutrophil count of 11.9 × 109/L, and neutrophil-to-lymphocyte ratio (NLR) of 5.2, above which length of hospital stay and PCPCS scores were less favorable. Furthermore, NLR was the second most important independent risk factor for a poor outcome (after GCS score). The IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI) adult TBI prediction model applied to this pediatric cohort demonstrated increased accuracy when WCC was incorporated as a risk factor.CONCLUSIONSIn the largest and first prospective study of isolated pediatric head injury to date, the authors have demonstrated that WCC > 16.1 × 109/L, neutrophil count > 11.9 × 109/L and NLR > 5.2 each have predictive value for lengthy hospital stay and poor PCPCS scores, and NLR is an independent risk factor for poor outcome. Incorporating the initial leukocyte count into TBI prediction models may improve prognostication.

Risk Factors for Withdrawal of Life-Sustaining Treatment in Severe Traumatic Brain Injury

2020 ◽  
Vol 86 (1) ◽  
pp. 8-14
Author(s):  
Sahil Gambhir ◽  
Areg Grigorian ◽  
Divya Ramakrishnan ◽  
Catherine M. Kuza ◽  
Brian Sheehan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Factors Associated ◽  
Severe Tbi ◽  
Life Sustaining Treatment

Studies demonstrate a significant variation in decision-making regarding withdrawal of life-sustaining treatment (WLST) practices for patients with severe traumatic brain injury (TBI). We investigated risk factors associated with WLST in severe TBI. We hypothesized age ≥65 years would be an independent risk factor. In addition, we compared survivors with patients who died in hospital after WLST to identify potential factors associated with in-hospital mortality. The Trauma Quality Improvement Program (2010–2016) was queried for patients with severe TBI of the head. Patients were compared by age (age < 65 and age ≥ 65 years) and survival after WLST (survivors versus non-survivors) at hospitalization discharge. A multivariable logistic regression model was used for analysis. From 1,403,466 trauma admissions, 328,588 (23.4%) patients had severe TBI. Age ≥ 65 years was associated with increased WLST (odds ratio: 1.76, confidence interval: 1.59–1.94, P < 0.001), whereas nonwhite race was associated with decreased WLST (odds ratio: 0.60, confidence interval: 0.55–0.65, P < 0.001). Compared with non-survivors of WLST, survivors were older (74 vs 61 years, P < 0.001) and more likely to have comorbidities such as hypertension (57% vs 38.5%, P < 0.001). Age ≥ 65 years was an independent risk factor for WLST, and nonwhite race was associated with decreased WLST. Patients surviving until discharge after WLST decision were older (≥74 years) and had multiple comorbidities.

Acute Lung Injury Is an Independent Risk Factor for Brain Hypoxia After Severe Traumatic Brain Injury

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 338-344 ◽  
Author(s):  
Mauro Oddo ◽  
Edjah Nduom ◽  
Suzanne Frangos ◽  
Larami MacKenzie ◽  
Isaac Chen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Acute Lung Injury ◽  
Brain Injury ◽  
Lung Injury ◽  
Severe Traumatic Brain Injury ◽  
Independent Risk Factor ◽  
Brain Hypoxia

scholarly journals A-126 Clinical Utility of Risk Factors to Predict Self-reported Neurobehavioral Outcome Following Traumatic Brain Injury: PTSD, Sleep, Resilience, and Lifetime Blast Exposure

2020 ◽  
Vol 35 (6) ◽  
pp. 919-919
Author(s):  
Lange R ◽  
Lippa S ◽  
Hungerford L ◽  
Bailie J ◽  
French L ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
Clinical Utility ◽  
Poor Sleep ◽  
Post Injury ◽  
Poor Outcome ◽  
Blast Exposure ◽  
Neurobehavioral Outcome

Abstract Objective To examine the clinical utility of PTSD, Sleep, Resilience, and Lifetime Blast Exposure as ‘Risk Factors’ for predicting poor neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 993 service members/veterans evaluated following an uncomplicated mild TBI (MTBI), moderate–severe TBI (ModSevTBI), or injury without TBI (Injured Controls; IC); divided into three cohorts: (1) &lt; 12 months post-injury, n = 237 [107 MTBI, 71 ModSevTBI, 59 IC]; (2) 3-years post-injury, n = 370 [162 MTBI, 80 ModSevTBI, 128 IC]; and (3) 10-years post-injury, n = 386 [182 MTBI, 85 ModSevTBI, 119 IC]. Participants completed a 2-hour neurobehavioral test battery. Odds Ratios (OR) were calculated to determine whether the ‘Risk Factors’ could predict ‘Poor Outcome’ in each cohort separately. Sixteen Risk Factors were examined using all possible combinations of the four risk factor variables. Poor Outcome was defined as three or more low scores (&lt; 1SD) on five TBI-QOL scales (e.g., Fatigue, Depression). Results In all cohorts, the vast majority of risk factor combinations resulted in ORs that were ‘clinically meaningful’ (ORs &gt; 3.00; range = 3.15 to 32.63, all p’s &lt; .001). Risk factor combinations with the highest ORs in each cohort were PTSD (Cohort 1 & 2, ORs = 17.76 and 25.31), PTSD+Sleep (Cohort 1 & 2, ORs = 18.44 and 21.18), PTSD+Sleep+Resilience (Cohort 1, 2, & 3, ORs = 13.56, 14.04, and 20.08), Resilience (Cohort 3, OR = 32.63), and PTSD+Resilience (Cohort 3, OR = 24.74). Conclusions Singularly, or in combination, PTSD, Poor Sleep, and Low Resilience were strong predictors of poor outcome following TBI of all severities and injury without TBI. These variables may be valuable risk factors for targeted early interventions following injury.

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