@article{ref1,
title="Prior traumatic brain injury is a risk factor for in-hospital mortality in moderate to severe traumatic brain injury: a TRACK-TBI cohort study",
journal="Trauma surgery and acute care open",
year="2024",
author="Yue, John K. and Etemad, Leila L. and Elguindy, Mahmoud M. and van Essen, Thomas A. and Belton, Patrick J. and Nelson, Lindsay D. and McCrea, Michael A. and Vreeburg, Rick J. G. and Gotthardt, Christine J. and Tracey, Joye X. and Coskun, Bukre C. and Krishnan, Nishanth and Halabi, Cathra and Eagle, Shawn R. and Korley, Frederick K. and Robertson, Claudia S. and Duhaime, Ann-Christine and Satris, Gabriela G. and Tarapore, Phiroz E. and Huang, Michael C. and Madhok, Debbie Y. and Giacino, Joseph T. and Mukherjee, Pratik and Yuh, Esther L. and Valadka, Alex B. and Puccio, Ava M. and Okonkwo, David O. and Sun, Xiaoying and Jain, Sonia and Manley, Geoffrey T. and DiGiorgio, Anthony M. and Badjatia, Neeraj and Barber, Jason and Bodien, Yelena G. and Fabian, Brian and Ferguson, Adam R. and Foreman, Brandon and Gardner, Raquel C. and Gopinath, Shankar and Grandhi, Ramesh and Russell Huie, J. and Dirk Keene, C. and Lingsma, Hester F. and Macdonald, Christine L. and Markowitz, Amy J. and Merchant, Randall and Ngwenya, Laura B. and Rodgers, Richard B. and Schneider, Andrea L. C. and Schnyer, David M. and Taylor, Sabrina R. and Temkin, Nancy R. and Torres-Espín, Abel and Vassar, Mary J. and Wang, Kevin K. W. and Wong, Justin C. and Zafonte, Ross D.",
volume="9",
number="1",
pages="e001501-e001501",
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. <br><br>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. <br><br>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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="2397-5776",
doi="10.1136/tsaco-2024-001501",
url="http://dx.doi.org/10.1136/tsaco-2024-001501"
}