Trauma Surgery & Acute Care Open (Jul 2024)
Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study
- ,
- Hester F Lingsma,
- Ramesh Grandhi,
- Amy J Markowitz,
- Debbie Y Madhok,
- Geoffrey T Manley,
- Jason Barber,
- Xiaoying Sun,
- Michael A McCrea,
- Kevin K W Wang,
- Lindsay D Nelson,
- Pratik Mukherjee,
- Neeraj Badjatia,
- Ava M Puccio,
- David O Okonkwo,
- Patrick J Belton,
- Sonia Jain,
- Nancy R Temkin,
- Cathra Halabi,
- Richard B Rodgers,
- Andrea L C Schneider,
- Shawn R Eagle,
- Shankar Gopinath,
- Randall Merchant,
- Ross D Zafonte,
- Raquel C Gardner,
- John K Yue,
- Leila L Etemad,
- Mahmoud M Elguindy,
- Thomas A van Essen,
- Rick J G Vreeburg,
- Christine J Gotthardt,
- Joye X Tracey,
- Bukre C Coskun,
- Nishanth Krishnan,
- Frederick K Korley,
- Claudia S Robertson,
- Ann-Christine Duhaime,
- Gabriela G Satris,
- Phiroz E Tarapore,
- Michael C Huang,
- Joseph T Giacino,
- Esther L Yuh,
- Alex B Valadka,
- Anthony M DiGiorgio,
- Yelena G Bodien,
- Brian Fabian,
- Adam R Ferguson,
- Brandon Foreman,
- J Russell Huie,
- C Dirk Keene,
- Christine L MacDonald,
- Laura B Ngwenya,
- David M Schnyer,
- Sabrina R Taylor,
- Abel Torres-Espin,
- Mary J Vassar,
- Justin C Wong
Affiliations
- Hester F Lingsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Ramesh Grandhi
- Department of Neurosurgery, University of Utah Health, Salt Lake City, Utah, USA
- Amy J Markowitz
- 3 Brain and Spinal Injury Center (BASIC), University of California, San Francisco, San Francisco, California, USA
- Debbie Y Madhok
- Department of Neurology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA
- Geoffrey T Manley
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
- Jason Barber
- 3 Neurosurgery, University of Washington, Seattle, Washington, USA
- Xiaoying Sun
- Peking University First Hospital, Department of Rheumatology and Clinical Immunology, Beijing, China
- Michael A McCrea
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Kevin K W Wang
- Lindsay D Nelson
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
- Neeraj Badjatia
- Division of Neurocritical Care, Department of Neurology, Columbia University Medical Center, Milstein Hospital 8-300 Center, New York, USA
- Ava M Puccio
- 3 Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- David O Okonkwo
- 3 Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Patrick J Belton
- 1Division of Neurosurgery, University of Missouri Columbia School of Medicine, Columbia, Missouri, USA
- Sonia Jain
- Department of Family Medicine and Public Health, Division of Biostatistics & Bioinformatics, University of California San Diego, La Jolla, California, USA
- Nancy R Temkin
- Associate professor of neurological surgery and biostatistics
- Cathra Halabi
- 4 Department of Neurology, University of California San Francisco, San Francisco, California, USA
- Richard B Rodgers
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
- Andrea L C Schneider
- 6 Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Shawn R Eagle
- Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Shankar Gopinath
- Randall Merchant
- Ross D Zafonte
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Raquel C Gardner
- 9 The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- John K Yue
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Leila L Etemad
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Mahmoud M Elguindy
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Thomas A van Essen
- Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands
- Rick J G Vreeburg
- Neurological Surgery, Leiden University Medical Center, Leiden, Netherlands
- Christine J Gotthardt
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Joye X Tracey
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Bukre C Coskun
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Nishanth Krishnan
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Frederick K Korley
- Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Claudia S Robertson
- Neurological Surgery, Baylor College of Medicine, Houston, Texas, USA
- Ann-Christine Duhaime
- Neurological Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
- Gabriela G Satris
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Phiroz E Tarapore
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Michael C Huang
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Joseph T Giacino
- Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, USA
- Esther L Yuh
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Alex B Valadka
- Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Anthony M DiGiorgio
- Neurological Surgery, University of California San Francisco, San Francisco, California, USA
- Yelena G Bodien
- Brian Fabian
- Adam R Ferguson
- Brandon Foreman
- J Russell Huie
- C Dirk Keene
- Christine L MacDonald
- Laura B Ngwenya
- David M Schnyer
- Sabrina R Taylor
- Abel Torres-Espin
- Mary J Vassar
- Justin C Wong
- DOI
- https://doi.org/10.1136/tsaco-2024-001501
- Journal volume & issue
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Vol. 9,
no. 1
Abstract
Objectives An estimated 14–23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.Methods Data from hospitalized subjects with Glasgow Coma Scale score of 3–12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014–2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1–3 (vs. 4–8)) at 3, 6, and 12 months after injury.Results Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01–4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.Conclusions After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed.Level of evidence IV.Trial registration number NCT02119182.
