Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2013 May;133(5):659-68.
doi: 10.1007/s00402-013-1710-0. Epub 2013 Mar 5.

Impact of concomitant injuries on outcomes after traumatic brain injury

Johannes Leitgeb  1 , Walter Mauritz, Alexandra Brazinova, Marek Majdan, Ingrid Wilbacher
Affiliations
Multicenter Study

Impact of concomitant injuries on outcomes after traumatic brain injury

Johannes Leitgeb et al. Arch Orthop Trauma Surg. 2013 May.

Abstract

Background: Patients with traumatic brain injury (TBI) frequently have concomitant injuries; we aimed to investigate their impact on outcomes.

Methods: Between February 2002 and April 2010, 17 Austrian centers prospectively enrolled 863 patients with moderate and severe TBI into observational studies. Data on accident, treatment, and outcomes were collected. Patients who survived until intensive care unit (ICU) admission and had survivable TBI were selected, and were assigned to "isolated TBI" or "TBI + injury" groups. Six-month outcomes were classified as "favorable" if Glasgow Outcome Scale (GOS) scores were five or four, and were classified as "unfavorable" if GOS scores were three or less. Univariate statistics (Fisher's exact test, t test, χ(2)-test) and logistic regression were used to identify factors associated with hospital mortality and unfavorable outcome.

Results: Of the 767 patients, 403 (52.5 %) had isolated TBI, 364 (47.5 %) had concomitant injuries. Patients with isolated TBI had higher mean age (53 vs. 44 years, P = 0.001); hospital mortality (30.0 vs. 27.2 %, P = 0.42) and rate of unfavorable outcome (50.4 vs. 41.8 %, P = 0.02) were higher, too. There were no significant mortality differences for factors like age groups, trauma mechanisms, neurologic status, CT findings, or treatment factors. Concomitant injuries were associated with higher mortality (33.3 vs. 12.5 %, P = 0.05) in patients with moderate TBI, and were significantly associated with more ventilation, ICU, and hospitals days. Logistic regression revealed that age, Glasgow Coma Scale score, pupillary reactivity, severity of TBI and CT score were the main factors that influenced outcomes.

Conclusions: Concomitant injuries have a significant effect upon the mortality of patients with moderate TBI. They do not affect the mortality in patients with severe TBI.

PubMed Disclaimer

References

    1. Kemp CD, Johnson JC, Riordan WP, Cotton BA. How we die: the impact of nonneurologic organ dysfunction after severe traumatic brain injury. Am Surg. 2008;74(9):866–872. - PubMed
    1. Lefering R, Paffrath T, Linker R, Bouillon B, Neugebauer EA. Head injury and outcome—what influence do concomitant injuries have? J Trauma. 2008;65(5):1036–1043. doi: 10.1097/TA.0b013e318184ee48. - DOI - PubMed
    1. Heinzelmann M, Platz A, Imhof HG. Outcome after acute extradural haematoma, influence of additional injuries and neurological complications in the ICU. Injury. 1996;27(5):345–349. doi: 10.1016/0020-1383(95)00223-5. - DOI - PubMed
    1. Rusnak M, Janciak I, Majdan M, Wilbacher I, Mauritz W. Severe traumatic brain injury in Austria VI: effects of guideline-based management. Wien Klin Wochenschr. 2007;119(1–2):64–71. doi: 10.1007/s00508-006-0765-0. - DOI - PubMed
    1. Bullock R, Chesnut RM, Clifton G, Ghajar J, Marion DW, Narayan RK, Newell DW, Pitts LH, Rosner MJ, Wilberger JW. Guidelines for the management of severe head injury. Brain Trauma Foundation. Eur J Emerg Med. 1996;3(2):109–127. doi: 10.1097/00063110-199606000-00010. - DOI - PubMed

Publication types

LinkOut - more resources