Pre-injury health status and excess mortality in persons with traumatic brain injury: A decade-long historical cohort study

Mollayeva, Tatyana; Hurst, Mackenzie; Chan, Vincy; Escobar, Michael; Sutton, Mitchell; Colantonio, Angela

doi:10.1016/j.ypmed.2020.106213

Cited by 10 publications

(10 citation statements)

References 59 publications

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“…All analyses were completed and reported using the testing dataset, and the training and validation datasets were used for internal validation. Multiple testing to detect a set of definable health status patterns in TBI vs. non-TBI diagnoses Health status preceding the injury event We evaluated the health status preceding a TBI event reported by previous studies 6 , 33 . From all the possible ICD-10 codes classifying patients' main and secondary diagnoses, a previous data mining and validation study identified 43 factors that were significantly overrepresented in patients with TBI compared to reference patients (individually matched based on sex, age, place of residence, and income quintile) within the 5 years preceding their TBI event.…”

Section: Methodsmentioning

confidence: 99%

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

Mollayeva

Tran

Chan

et al. 2022

Sci Rep

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For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, computation implementation and vast patient data repositories can enable a concurrent analysis of personal, social, and environmental processes, providing insight into changes in health status transitions over time. We applied computational and data visualization techniques to categorize decade-long health records of 235,003 patients with TBI in Canada, from preceding injury to the injury event itself. Our results highlighted that health status transition patterns in TBI emerged along with the projection of comorbidity where many disorders, social and environmental adversities preceding injury are reflected in external causes of injury and injury severity. The strongest associations between health status preceding TBI and health status at the injury event were between multiple body system pathology and advanced age-related brain pathology networks. The interwoven aspects of health status on a time continuum can influence post-injury trajectories and should be considered in TBI risk analysis to improve prevention, diagnosis, and care.

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Section: Methodsmentioning

confidence: 99%

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

Mollayeva

Tran

Chan

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…We evaluated the health status preceding a TBI event reported by previous studies 6,32,33 . From all the possible ICD-10 codes classifying patients' main and associated diagnoses, a previous data mining and validation study identified 43 factors that were significantly overrepresented in patients with TBI compared to reference patients (individually matched based on sex, age, place of residence, and income quintile) within the 5 years preceding their TBI event.…”

Section: Health Status Preceding the Injury Eventmentioning

confidence: 99%

Health Status Transitions Related to Traumatic Brain Injury.

Escobar

Mollayeva

Tran

et al. 2021

Preprint

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For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, however, computation implementation and vast patient data repositories are producing datasets of such volume and complexity as to challenge traditional scientific methodology. Drastically different approaches show great promise for research on TBI. We report a computational analysis of health status over time using population-wide health administrative data of patients with TBI. Our approach facilitates health status at injury event evaluation and classification, and unfolds health status trajectories, from that of preceding injury to the injury event itself, as they concern external causes of injury and injury severity. Taken together, the contrasting and interwoven aspects of health status on a time continuum can influence injury event trajectories and should be considered in TBI risk analysis for the improvement of diagnosis, treatment, and prevention.

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“…2 Age and preexisting medical conditions also influence outcome. [3][4][5][6] The elderly often have a less physiological reserve capacity making them more prone to poor prognosis even after a less severe TBI. 2,3,7 Whether early mobilization in ICU for patients with severe TBI is beneficial or harmful, is still not clear.…”

Section: Introductionmentioning

confidence: 99%

Selecting patients for early interdisciplinary rehabilitation during neurointensive care after moderate to severe traumatic brain injury

Alvsåker

Hanoa

Olasveengen

2023

Acta Anaesthesiol Scand

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BackgroundEarly interdisciplinary rehabilitation (EIR) in neurointensive care is a limited resource reserved for patients with moderate to severe traumatic brain injury (TBI) believed to profit from treatment. We evaluated how key parameters related to injury severity and patient characteristics were predictive of receiving EIR, and whether these parameters changed over time.MethodsAmong 1003 adult patients with moderate to severe TBI admitted over 72 h to neurointensive care unit during four time periods between 2005 and 2020, EIR was given to 578 and standard care to 425 patients. Ten selection criteria thought to best represent injury severity and patient benefit were evaluated (Glasgow Coma Scale, Head Abbreviated Injury Scale, New‐Injury‐Severity‐Scale, intracranial pressure monitoring, neurosurgery, age, employment, Charlson Comorbidity Index, severe psychiatric disease, and chronic substance abuse).ResultsIn multivariate regression analysis, patients who were employed (adjOR 1.99 [95% CI 1.41, 2.80]), had no/mild comorbidity (adjOR 3.15 [95% CI 1.72, 5.79]), needed neurosurgery, had increasing injury severity and were admitted by increasing time period were more likely to receive EIR, whereas receiving EIR was less likely with increasing age (adjOR 0.97 [95% CI 0.96, 0.98]) and chronic substance abuse. Overall predictive ability of the model was 71%. Median age and comorbidity increased while employment decreased from 2005 to 2020, indicating patient selection became less restrictive with time.ConclusionInjury severity and need for neurosurgery remain important predictors for receiving EIR, but the importance of age, employment, and comorbidity have changed over time. Moderate prediction accuracy using current clinical criteria suggest unrecognized factors are important for patient selection.

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Pre-injury health status and excess mortality in persons with traumatic brain injury: A decade-long historical cohort study

Cited by 10 publications

References 59 publications

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event

Health Status Transitions Related to Traumatic Brain Injury.

Selecting patients for early interdisciplinary rehabilitation during neurointensive care after moderate to severe traumatic brain injury

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