Literature DB >> 20103393

Mortality after discharge from acute care hospitalization with traumatic brain injury: a population-based study.

Thomedi Ventura1, Cynthia Harrison-Felix, Nichole Carlson, Carolyn Diguiseppi, Barbara Gabella, Allen Brown, Michael Devivo, Gale Whiteneck.   

Abstract

UNLABELLED: Ventura T, Harrison-Felix C, Carlson N, DiGuiseppi C, Gabella B, Brown A, DeVivo M, Whiteneck G. Mortality after discharge from acute care hospitalization with traumatic brain injury: a population-based study.
OBJECTIVE: To characterize mortality after acute hospitalization with traumatic brain injury (TBI) in a socioeconomically diverse population.
DESIGN: Population-based retrospective cohort study.
SETTING: Statewide TBI surveillance program. PARTICIPANTS: Colorado residents with TBI discharged alive from acute hospitalization between 1998 and 2003 (N=18,998).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Vital status at the end of the study period (December 31, 2005) and statewide population mortality rates were used to calculate all-cause and cause-specific standardized mortality ratios (SMRs) and life expectancy compared with population mortality rates. The influence of demographics, injury severity, and comorbid conditions on time until death was investigated using age-stratified Cox proportional hazards modeling.
RESULTS: Patients with TBI carried about 2.5 times the risk of death compared with the general population (SMR=2.47; 95% confidence interval [CI], 2.31-2.65). Life expectancy reduction averaged 6 years. SMRs were largest for deaths caused by mental/behavioral (SMR=3.84; 95% CI, 2.67-5.51) and neurologic conditions (SMR=2.79; 95% CI, 2.07-3.77) and were smaller but significantly higher than 1.0 for an array of other causes. Injury severity and older age increased mortality among young people (age <20y). However, risk factors for mortality among adults age 20 and older involved multiple domains of demographics (eg, metropolitan residence), injury-related measures (eg, falls versus vehicular incidents), and comorbidity (eg, > or =3 comorbid health conditions versus none).
CONCLUSIONS: TBI confers an increased risk of mortality in the months and years after hospital discharge. Although life expectancy is reduced across the population, the excess in mortality lessens as time since injury increases. Specific risk factors (eg, high injury severity, poor general health) pose an especially high threat to survival and should prompt an increased vigilance of health status, especially among younger patients. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 20103393     DOI: 10.1016/j.apmr.2009.08.151

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


  38 in total

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2.  Quality of care indicators for the rehabilitation of children with traumatic brain injury.

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3.  Population-based incidence and 5-year survival for hospital-admitted traumatic brain and spinal cord injury, Western Australia, 2003-2008.

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4.  Post-Discharge Mortality of Older Adults with Traumatic Brain Injury or Other Trauma.

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5.  Global Outcome Trajectories After TBI Among Survivors and Nonsurvivors: A National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems Study.

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6.  Long-term survival after traumatic brain injury: a population-based analysis controlled for nonhead trauma.

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7.  Suicide, fatal injuries, and other causes of premature mortality in patients with traumatic brain injury: a 41-year Swedish population study.

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8.  The Safety Assessment Measure for persons with traumatic brain injury: Item pool development and content validity.

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9.  Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury.

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10.  Life Expectancy after Inpatient Rehabilitation for Traumatic Brain Injury in the United States.

Authors:  Cynthia Harrison-Felix; Christopher Pretz; Flora M Hammond; Jeffrey P Cuthbert; Jeneita Bell; John Corrigan; A Cate Miller; Juliet Haarbauer-Krupa
Journal:  J Neurotrauma       Date:  2014-11-04       Impact factor: 5.269

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