Multicenter Retrospective Cohort Study of “Talk and Die” After Traumatic Brain Injury

Shibahashi, Keita; Sugiyama, Kazuhiro; Okura, Yoshihiro; Hoda, Hidenori; Hamabe, Yuichi

doi:10.1016/j.wneu.2017.07.117

Cited by 32 publications

(42 citation statements)

References 13 publications

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“…These studies were penalised because of biases on multiple levels, four or more out of seven criteria of biases. A total of 2722–48 studies, all of ‘moderate’ quality, were included for data analysis (figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…A summary of the included studies is presented in Table 1, online supplementary tables 3 and 4. Among the 27 studies, 14 were population based23 25 26 28 29 33–37 40 41 44 45 and 13 were clinical studies 22 24 27 30–32 38 39 42 43 46–48. Of the 14 population-based studies, all but one used a retrospective cohort design 29.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 13 clinical studies, four used a prospective cohort methodology22 27 39 43 and nine used a retrospective cohort methodology 24 30–32 38 42 46. With respect to TBI severity, 10 studies included patients of all TBI severities,29 32 33 35–37 39 41 43 46 six studies included moderate and severe TBI cases,24 30 38 45 47 48 and one study included patients with mild TBI 22. The remaining 10 studies did not report information on TBI severity 23 25–28 31 34 40 42 44…”

Section: Resultsmentioning

confidence: 99%

“…Among the studies that included age within their final multivariate models, 14 found a significant relationship between increasing age and both short-term and long-term mortality,23 25 28 29 31–33 35 37 40 41 43–45 47 48 two studies did not identify any significant relationship30 46 and one study found an increased rate ratio of long-term mortality for the younger age groups compared with the older age groups (≥50 years of age) 26. Effect sizes varied greatly as shown in table 1.…”

Section: Resultsmentioning

confidence: 99%

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Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

et al. 2019

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ObjectivesComorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.DesignSystematic review.Data sourcesMedline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesisTwo independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.ResultsA total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.ConclusionsGiven the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration numberCRD42017070033

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

et al. 2019

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“…A recent analysis confirmed that cranial vault fracture (CVF) is an independent risk factor of mortality in patients after TBI who were able to talk on admission. 6 Management of patients with SF is generally conservative; however, some of them may require neurosurgical intervention due to bleeding with increased intracranial pressure, penetrating trauma, or CSF leakage. Defining the prognostic value of various clinical findings could be of great importance for developing decision-making algorithms.…”

Section: Introductionmentioning

confidence: 99%

Predicting Outcome and Conservative Treatment Failure in Patients with Skull Fracture after Traumatic Brain Injury: A Retrospective Cohort Study

Bobeff

Posmyk

Bobeff

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Objective Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide. The prognostic value of skull fracture (SF) remains to be clearly defined. To evaluate the need for neurosurgical intervention and determine the risk factors of conservative treatment failure (CTF), we retrieved from the hospital database the records of patients with SF after TBI. Methods We analyzed 146 consecutive patients (mean age: 49.8 ± 17.5 years) treated at the department of neurosurgery in a 5-year period. Clinical data, radiologic reports, and laboratory results were evaluated retrospectively. Results A total of 63% of patients were treated conservatively, 21.9% were operated on immediately, and 15.1% experienced CTF. Overall, 73.3% had a favorable outcome; the mortality rate was 13%. Intracranial bleeding occurred in 96.6% of cases, basilar SF in 61%, and cerebrospinal fluid (CSF) leak in 2.8%. The independent risk factors for outcome were Glasgow Coma Scale (GCS) score, age, and platelet count (PCT). The independent risk factors for CTF were epidural hematoma, subdural hematoma, mass effect, edema, international normalized ratio, PCT, mean platelet volume, and CSF leakage. The consensus decision tree algorithm used at the accident and emergency department indicated patients with no need for neurosurgical intervention with an accuracy of 91.7%, sensitivity of 88.9%, and featured the importance of mass effect, GCS, and epidural hematoma. Conclusions Tests included in the complete blood count appeared useful for predicting the course in patients with SF, although the most important factors were age and neurologic status, as well as radiologic findings. Our decision tree requires further validation before it can be used in everyday practice.

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Mortality of hospital walk‐in trauma patients: a multicenter retrospective cohort study

Kakimoto

Shibahashi

Oishio

et al. 2022

Acute Medicine & Surgery

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To investigate the characteristics of patients who visited the emergency department by themselves after experiencing trauma and subsequently died, and to identify the prognostic factors of mortality in such patients.Methods: Adult patients with trauma visiting the emergency department by themselves between 2004 and 2019 in Japan were identified using a nationwide trauma registry (the Japan Trauma Data Bank). The characteristics of patients who died were compared with those who survived, and multivariable logistic regression analysis was used to determine the independent association of each preselected variable with in-hospital mortality (end-point).Results: Of the 9753 patients eligible for analysis, 4369 (44.8%) were men, and the median age was 75 years. Of these patients, 130(1.3%) died in the hospital. The following factors had a significant association with in-hospital mortality: age, male sex, Charlson Comorbidity Index (CCI) 3-4 and ≥5 with CCI = 0 as a reference, circumstances of injury (free fall and fall at ground level), Glasgow Coma Scale score, Shock Index ≥ 0.9, severe injuries of the head, abdomen and lower extremities, and Injury Severity Score ≥ 15.Conclusions: Several risk factors, including older age, male sex, higher CCI, circumstances of injury (free fall and fall at ground level), lower Glasgow Coma Scale score, higher Shock Index, and severe injuries of the head, abdomen, and lower extremities, were identified as being associated with the death of trauma patients visiting the emergency department by themselves. Early identification of patients with these risk factors and appropriate treatment may reduce mortality posttrauma.

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Multicenter Retrospective Cohort Study of “Talk and Die” After Traumatic Brain Injury

Cited by 32 publications

References 13 publications

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

Predicting Outcome and Conservative Treatment Failure in Patients with Skull Fracture after Traumatic Brain Injury: A Retrospective Cohort Study

Mortality of hospital walk‐in trauma patients: a multicenter retrospective cohort study

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