Citation

Sánchez AI, Krafty RT, Weiss HB, Rubiano AM, Peitzman AB, Puyana JC. J. Head Trauma Rehabil. 2012; 27(2): 159-169.

Affiliation

Departments of Surgery (Drs Sánchez, Peitzman, and Puyana) and Statistics (Dr Krafty), University of Pittsburgh, Pittsburgh, Pennsylvania; CISALVA Institute, Universidad del Valle, Cali, Colombia (Dr Sánchez); Injury Prevention Research Unit, University of Otago, Dunedin, New Zealand (Dr Weiss); and Department of Neurosciences, South Colombian University, Critical Care Unit, Neiva University Hospital, Neiva, Colombia (Dr Rubiano).

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0b013e3182074c41

PMID

21386713

PMCID

PMC3143237

Abstract

OBJECTIVE:: To determine trends for in-hospital survival and functional outcomes at acute care hospital discharge forpatients with severe adult traumatic brain injury (SATBI) in Pennsylvania, during 1998 to 2007. METHODS:: Secondary analysisof the Pennsylvania trauma outcome study database. MAIN OUTCOME MEASURES:: Survival and functional status scores of 5 domains(feeding, locomotion, expression, transfer mobility, and social interaction) fitted into logistic regression models adjusted for age, sex,race, comorbidities, injury mechanism, extracranial injuries, severity scores, hospital stay, trauma center, and hospital level.Sensitivity analyses for functional outcomes were performed. RESULTS:: There were 26 234 SATBI patients. Annual numbersof SATBI increased from 1757 to 3808 during 1998 to 2007. Falls accounted for 47.7% of all SATBI. Survival increased significantlyfrom 72.5% to 82.7% (odds ratio [OR] = 1.10, 95% CI: 1.08-1.11, P < .001). Insensitivity analyses, trends of complete independence in functional outcomes increased significantly for expression (OR = 1.01,95% CI: 1.00-1.02, P = .011) and social interaction (OR = 1.01, 95% CI: 1.00-1.03, P= .002). There were no significant variations over time for feeding, locomotion, and transfer mobility. Conclusions:Trends for SATBI served by Pennsylvania's established trauma system showed increases in rates but substantial reductions in mortalityand significant improvements in functional outcomes at discharge for expression and social interaction.

Language: en