The risk of pulmonary tuberculosis after traumatic brain injury

Abstract

After traumatic brain injury (TBI), an inflammatory response in the brain might affect the immune system. The risk of pulmonary infection reportedly increases in patients with TBI. We aimed to evaluate the risk of tuberculosis (TB) in patients with TBI in Taiwan. All participants were selected from the intensive care unit (ICU). Patients with TBI were defined as patients in ICU with intracranial injury, and comparison cohort were patients in ICU without TBI diagnosis. There was a significant difference in TB risk between the patients with TBI and the comparison cohort according to age and the Charlson’s comorbidity index (CCI) score. Thus, we divided patients based on CCI into three groups for further analysis: mild (CCI = 0), moderate (CCI = 1/2), severe (CCI > 2). Mild-CCI group had a lower TB incidence rate (0.74%) and longer time to TB development (median: 2.43) than the other two groups. Moderate-CCI group had 1.52-fold increased risk of TB infection (p < 0.0001) compared with mild-CCI group. In the severe-CCI group, patients aged ≥ 80 years had 1.91-fold risk of TB compared with mild-CCI group (p = 0.0481). Severe-CCI group had significantly higher mortality than the mild-CCI group (p = 0.0366). Patients with TBI and more comorbidities had higher risk of TB infection with higher mortality rate.

Tongqiao Huoxue Decoction ameliorates traumatic brain injury‐induced gastrointestinal dysfunction by regulating CD36/15‐LO/NR4A1 signaling, which fails when CD36 and CX3CR1 are deficient

“…Traumatic brain injury (TBI) is a complicated condition well known to be not only injurious to the brain but also detrimental to numerous organ systems, including the gastrointestinal (GI), 1 cardiovascular, 2 and respiratory systems 3 . Increasing evidence suggests that TBI can result in GI dysfunction, which primarily refers to intestinal inflammation and destruction of the intestinal mucosal barrier (IMB) 4–6 .…”

“…Traumatic brain injury (TBI) is a complicated condition well known to be not only injurious to the brain but also detrimental to numerous organ systems, including the gastrointestinal (GI), 1 cardiovascular, 2 and respiratory systems. 3 Increasing evidence suggests that TBI can result in GI dysfunction, which primarily refers to intestinal inflammation and destruction of the intestinal mucosal barrier (IMB). 4 , 5 , 6 Furthermore, GI dysfunction can cause a lack of appetite, 7 increased rates of bacterial translocation and infection, 8 and disorders of the immune system, 9 which ultimately raise the mortality rate of TBI patients.…”