scholarly journals Effectiveness of Early Tracheostomy compared with Late Tracheostomy Or Prolonged Orotracheal Intubation in Traumatic Brain Injury: Protocol of Systematic Review

2022 ◽  
Author(s):  
RAUL RIBEIRO DE ANDRADE ◽  
◽  
OLAVO BARBOSA DE OLIVEIRA NETO ◽  
JOÃO GUSTAVO ROCHA PEIXOTO DOS SANTOS ◽  
CÉLIO FERNANDO DE SOUSA RODRIGUES ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Web Of Science ◽  
Public Health Problem ◽  
Orotracheal Intubation ◽  
Early Tracheostomy ◽  
Trial Register ◽  
Review Question ◽  
Clinical Trials Registry ◽  
Clinical Trial Register

Review question / Objective: What is the effectiveness of Early Tracheostomy compared with Late Tracheostomy Or Prolonged Orotracheal Intubation in Traumatic Brain Injury? Condition being studied: Traumatic Brain Injury (TBI) is every traumatic anatomical ou functional injury that affects brain, skull and/or vessels related to them. TBI is a public health problem that involves over 50 million people per year in Worldwide. Information sources: PUBLISHED DATABASES (Medline by PUBMED, Lilacs, Central-Cochrane, Scopus by Elsevier, Web Of Science e Embase by Elsevier) NON-PUBLISHED (Open Grey by Sigle; Clinical Trial Register at the International Clinical Trials Registry Platform) (Referencies of the selected studies).

scholarly journals Association between suicide risk and traumatic brain injury in adults: a population based cohort study

2020 ◽  
pp. postgradmedj-2019-136860 ◽  
Author(s):  
Yueh-Chien Lu ◽  
Ming-Kung Wu ◽  
Li Zhang ◽  
Cong-Liang Zhang ◽  
Ying-Yi Lu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cause Of Death ◽  
Suicide Risk ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Population Based ◽  
Research Database ◽  
Global Public Health

BackgroundTraumatic brain injury (TBI) is a major cause of death and disability worldwide, and its treatment is potentially a heavy economic burden. Suicide is another global public health problem and the second leading cause of death in young adults. Patients with TBI are known to have higher than normal rates of non-fatal deliberate self-harm, suicide and all-cause mortality. The aim of this study was to explore the association between TBI and suicide risk in a Chinese cohort.MethodThis study analysed data contained in the Taiwan National Health Insurance Research Database for 17 504 subjects with TBI and for 70 016 subjects without TBI matched for age and gender at a ratio of 1 to 4. Cox proportional hazard regression analysis was used to estimate subsequent suicide attempts in the TBI group. Probability of attempted suicide was determined by Kaplan-Meier method.ResultsThe overall risk of suicide attempts was 2.23 times higher in the TBI group compared with the non-TBI group (0.98 vs 0.29 per 1000 person-years, respectively) after adjustment for covariates. Regardless of gender, age or comorbidity, the TBI group tended to have more suicide attempts, and the risk attempted suicide increased with the severity of TBI. Depression and alcohol attributed disease also increased the risk of attempted suicide in the TBI group.ConclusionSuicide is preventable if risk factors are recognised. Hence, TBI patients require special attention to minimise their risk of attempted suicide.

Early versus Late Tracheostomy: Is There an Outcome Difference?

2019 ◽  
Vol 85 (4) ◽  
pp. 370-375 ◽  
Author(s):  
Adel Elkbuli ◽  
Raed Ismail Narvel ◽  
Paul J. Spano ◽  
Valerie Polcz ◽  
Astrid Casin ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Primary Outcome ◽  
Injury Severity ◽  
Future Research ◽  
Trauma Patients ◽  
Early Tracheostomy ◽  
Outcome Difference ◽  
The Impact

The effect of timing in patients requiring tracheostomy varies in the literature. The purpose of this study was to evaluate the impact of early tracheostomy on outcomes in trauma patients with and without traumatic brain injury (TBI). This study is a four-year review of trauma patients undergoing tracheostomy. Patients were divided into two groups based on TBI/non-TBI. Each group was divided into three subgroups based on tracheostomy timing: zero to three days, four to seven days, and greater than seven days postadmission. TBI patients were stratified by the Glasgow Coma Scale (GCS), and non-TBI patients were stratified by the Injury Severity Score (ISS). The primary outcome was ventilator-free days (VFDs). Significance was defined as P < 0.05. Two hundred eighty-nine trauma patients met the study criteria: 151 had TBI (55.2%) versus 138 (47.8%) non-TBI. There were no significant differences in demographics within and between groups. In TBI patients, statistically significant increases in VFDs were observed with GCS 13 to 15 for tracheostomies performed in four to seven versus greater than seven days ( P = 0.005). For GCS <8 and 8 to 12, there were significant increases in VFDs for tracheostomies performed at days 1 to 3 and 4 to 7 versus greater than seven days (P << 0.05 for both). For non-TBI tracheostomies, only ISS ≥ 25 with tracheostomies performed at zero to three days versus greater than seven days was associated with improved VFDs. Early tracheostomies in TBI patients were associated with improved VFDs. In trauma patients with no TBI, early tracheostomy was associated with improved VFDs only in patients with ISS ≥ 25. Future research studies should investigate reasons TBI and non-TBI patients may differ.

scholarly journals Early rehabilitation intervention is associated with significant positive functional outcomes in traumatic brain injury: a retrospective analysis

2021 ◽  
Author(s):  
Siddharth Rai ◽  
Mallikarjun Gunjiganvi ◽  
Awale Rupali Bhalachandra ◽  
Harleen Uppal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Retrospective Analysis ◽  
Trauma Center ◽  
Public Health Problem ◽  
Early Rehabilitation ◽  
Functional Improvement ◽  
Ethic Committee Approval ◽  
The Impact

Background: Traumatic brain injury (TBI) is a global public health problem affecting adversely health care system. While acute trauma care has been documented to improve outcomes, the impact of early rehabilitation on outcome is not well documented especially in the developing world like ours. Predicting functional outcome from admission variables helps in intervention development, and appropriate fund allocation for TBI treatment. Therefore, we accepted a challenge to do a retrospective study on TBI patients admitted in our newly established and resource limited trauma center. The aim of the study was to assess the effect of early rehabilitation on TBI patients on functional improvement and to prognosticate the improvement from early admission variables.Methods: Study was conducted at Apex Trauma Center, SGPGIMS, Lucknow analysis of prospectively maintained data. Retrospective analysis of records of patients, admitted within 48 hrs of moderate to severe injury, was done after Institute Ethic Committee approval. Statistical analysis used was regression analysis and multivariate analysis was done between possible risk factors and FIM gain.Results: There was significant FIM score improvement from admission to discharge (p<0.001). Factors associated with a higher FIM gain were admission FIM motor and cognitive scores, GCS score on admission and length of hospital stay.Conclusions: Our study strongly suggests that a dedicated rehabilitation programme, designed according to the functional needs of TBI patient, helps in improved functional outcome and recovery.

scholarly journals Patterns and Outcome of Traumatic Brain Injury Patients: A Study in a Tertiary Level Military Hospital

2020 ◽  
Vol 15 (1) ◽  
pp. 75-78
Author(s):  
Md Shohidul Islam ◽  
Md Fashiur Rahman ◽  
Md Aminul Islam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Surgical Intervention ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Public Health Problem ◽  
Armed Forces ◽  
Military Hospital

Introduction: A traumatic brain injury (TBI) is an injury to the brain caused by an impact to the head. TBI represents a huge global medical and public health problem across all ages and in both civilian and military populations. TBI is characterized by great heterogeneity in terms of etiology, mechanism, pathology, severity and treatment with widely varying outcomes. Objective: To determine the pattern and outcome of traumatic brain injuries in victims reported to emergency and casualty (E&C) department following intensive care with or without surgical intervention. Materials and Methods: This prospective type of observational study was conducted at Neurosurgery department of Combined Military Hospital, Dhaka from October 2013 to March 2017. A total of 675 head injury patients with TBI were assessed with gender, age, cause and type of trauma, GCS on admission, associated other injuries, time lapsed from trauma to hospitalization and care given. The outcome was measured after 72 hours using Glasgow Outcome Scale (GOS). Results: The incidence of TBI was 47.03% among the head injury patients. Common age group was 21-30 years (43.7%) and male victims (66.55%). RTA was the most frequent cause (50.05%) of TBI and the most common pathophysiological cause of TBI was subdural haemorrhage (SDH)(35%) followed by extradural haemorrhage (EDH)(27%). Most patients (45%) had mild TBI. Surgical intervention was required in 45% patients of TBI mainly for the SDH, EDH which had significant positive effect on the TBI patient’s outcome. The majority of patients (77%) had good outcome which included recovery (51.85%) and moderate disability (25.48%). The poor outcome was observed in 23% patients which included death (7.40%), persistent vegetative state (3.11%), severe disability (12.14%) and it was associated with older age, severe TBI (GCS<8 on admission), associated other injuries and delayed resuscitative care and interventions. Conclusion: TBI was common among the young adults male. The RTA was the leading cause of TBI. The factors that influence the outcome of TBI include patient’s age, severity of TBI, associated injuries and delayed resuscitative care. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 75-78

scholarly journals A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Marthe Ford ◽  
Gert J. Geurtsen ◽  
Erny Groet ◽  
Coen A.M. Van Bennekom ◽  
Eus J.W. Van Someren
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Behavioral Therapy ◽  
Cognitive Functioning ◽  
Behavioral Therapy ◽  
Acquired Brain Injury ◽  
Cognitive Behavioral ◽  
Face To Face ◽  
Trial Register ◽  
Insomnia Severity

Abstract Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioral therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioral treatment in this population are scarce, and this applies even more for studies on online cognitive behavioral therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioral therapy for insomnia following acquired brain injury.Methods: A multicenter, prospective, randomized, open-label, blinded end point study (PROBE) will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioral therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioral therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioral therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018

scholarly journals Comparing the Outcomes of Early and Late Tracheostomy in Severe Traumatic Brain Injury Patient

2021 ◽  
Vol 28 (4) ◽  
pp. 63-70
Author(s):  
Muhammad Ihfaz Ismail ◽  
Zamzuri Idris ◽  
Jafri Malin Abdullah ◽  
Noor Azman A Rahman ◽  
Mazin Nordin
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Early Tracheostomy ◽  
Prolonged Intubation ◽  
High Dependency ◽  
Severe Tbi ◽  
Injury Patient ◽  
The Mean ◽  
Logistic Regression Test

Background: Patients with severe traumatic brain injury (TBI) were expected to have poor Glasgow Coma Scale (GCS) recovery and prolonged intubation. Therefore, an early tracheostomy procedure was indicated for all severe TBI. In view of growing concern regarding the safety and outcome of early tracheostomy on these patients, it was deemed valid and needed to be addressed. Methods: This study was conducted to compare the outcomes of early and late tracheostomies in severe TBI. Only severe TBI patients who were admitted to the Neurosurgery High Dependency Unit (NHDU), Hospital Sultanah Aminah (HSA), Johor Bahru, Johor, Malaysia and who had underwent a tracheostomy were recruited. Three main outcomes noted: duration on ventilation, length of NHDU stay and rate of ventilator associated pneumonia (VAP). Results: Out of 155 patients, 72 (46.5%) were in early tracheostomy group (ETG) and 83 (53.5%) were in late tracheostomy group (LTG). The majority of the participants, 95 (61.3%) were ethnic Malays. The mean duration on ventilator use was 2.65 days (1.57) for ETG and 5.63 days (2.35) for LTG. While, mean NHDU stay was 4.75 days (1.98) for ETG and 9.77 days (2.70) for LTG. Upon independent t-test, early duration of tracheostomies had shown significant outcome in reducing length of NHDU stay, (P < 0.001) and had shortening participants’ time on mechanical ventilator (P < 0.001). Then, based on forward multiple logistic regression test, there were significant association between comorbid (P = 0.003) and tracheostomy (P = 0.020) towards presence of VAP when adjusted for other variables. Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of VAP.

scholarly journals Epidemiology of Pediatric Traumatic Brain Injury in Brazil

2021 ◽  
Author(s):  
Leandro Cândido de Souza ◽  
Ricardo Santos de Oliveira ◽  
Francisco de Assis Carvalho do Vale ◽  
Matheus Fernando Manzolli Ballestero
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Admissions ◽  
Pediatric Population ◽  
Case Fatality ◽  
Public Health Problem ◽  
Emerging Countries ◽  
Pediatric Traumatic Brain Injury ◽  
Important Public Health Problem ◽  
Pediatric Tbi

Background: Pediatric traumatic brain injury (TBI) is a serious social and economic problem. Emerging countries have 89% of the cases worldwide and lack relevant epidemiological studies on the subject. Objectives: Characterize the demographic, social and economic profiles of the pediatric population suffering TBI in Brazil. Methods: Data on the cases of pediatric TBI in Brazil between 2008 and 2020 were collected through the computer department of the Unified Health System (DATASUS) maintained by the Brazilian Ministry of Health. Results: There are about 28,836 hospital admissions due to pediatric TBI per year and an incidence of 45.11 admissions /100,000/year. The in-hospital mortality rate was 1.47/100,000/year, and the case fatality rate was 3.26%. The average annual cost of hospital expenses was US$ 12.311.759, with the average admission cost having a value of US $417. The 15–19 age group was the most frequently admitted to hospital for pediatric TBI and had the highest number of in- hospital deaths; in addition, more males were affected by this trauma compared to females at a rate of 2.31:1. Ethnic populations that are social minorities are more susceptible to a poor prognosis of TBI. Conclusion: Pediatric TBI should be recognized as an important public health problem in Brazil, as it is responsible for considerable social and economic costs. Public policies that reduce the causes of this type of trauma in the pediatric population are urgently needed in Brazil and other emerging countries.

scholarly journals A Survey about Surgical Preferences in Operative Technique in Decompressive Craniectomy in Traumatic Brain Injury

2013 ◽  
Vol 2 (3) ◽  
pp. 106-111
Author(s):  
Andres M Rubiano ◽  
Hernando Raphael Alvis-Miranda ◽  
Gabriel Alcalá-Cerra ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Health Problem ◽  
Operative Technique ◽  
Public Health Problem ◽  
Neurosurgical Procedure

ABSTRACT Traumatic brain injury is a public health problem. The control of intracranial hypertension is a key strategy for managing this type of patients. Decompressive craniectomy is a measure of second level for the control of intracranial hypertension refractory to medical management. In order to assess trends in relationship to the management of decompressive craniectomy, a survey was designed and sent to neurosurgeons from various countries. We discuss the results for a better standardization of surgical techinique. Decompressive craniectomy is a saving technique and usefulness depend on a correct realization of the neurosurgical procedure. How to cite this article Alvis-Miranda HR, Alcala-Cerra G, Rubiano AM, Moscote-Salazar LR. A Survey about Surgical Preferences in Operative Technique in Decompressive Craniectomy in Traumatic Brain Injury. J Trauma Critical Care Emerg Surg 2013;2(3):106-111.

scholarly journals Connectomic Assessment of Injury Burden and Longitudinal Structural Network Alterations in Moderate-to-severe Traumatic Brain Injury

2021 ◽  
Author(s):  
Yusuf Osmanlioglu ◽  
Drew Parker ◽  
Jacob A Alappatt ◽  
James J Gugger ◽  
Ramon R Diaz-Arrastia ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Structural Connectivity ◽  
Public Health Problem ◽  
Brain Regions ◽  
Brain Network ◽  
Major Public Health Problem ◽  
Post Injury ◽  
Structural Network ◽  
Injury Burden

Traumatic brain injury (TBI) is a major public health problem. Caused by external mechanical forces, a major characteristic of TBI is the shearing of axons across the white matter, which causes structural connectivity disruptions between brain regions. This diffuse injury leads to cognitive deficits, frequently requiring rehabilitation. Heterogeneity is another characteristic of TBI as severity and cognitive sequelae of the disease have a wide variation across patients, posing a big challenge for treatment. Thus, measures assessing network-wide structural connectivity disruptions in TBI are necessary to quantify injury burden of individuals, which would help in achieving personalized treatment, patient monitoring, and rehabilitation planning. Despite TBI being a disconnectivity syndrome, connectomic assessment of structural disconnectivity has been very scarce. In this study, we propose a novel connectomic measure that we call network anomaly score (NAS) to capture the integrity of structural connectivity in TBI patients by leveraging two major characteristics of the disease: diffuseness of axonal injury and heterogeneity of the disease. Over a longitudinal cohort of moderate-to-severe TBI patients, we demonstrate that structural network topology of patients are more heterogeneous and are significantly different than that of healthy controls at 3 months post-injury, where dissimilarity further increases up to 12 months. We also show that NAS captures injury burden as quantified by post-traumatic amnesia and that alterations in the structural brain network is not related to cognitive recovery. Finally we compare NAS to major graph theory measures used in TBI literature and demonstrate the superiority of NAS in characterizing the disease.

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