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
. 2016;25(5):435-41.
doi: 10.1159/000447566. Epub 2016 Jul 7.

Twenty-Eight-Day Mortality of Blunt Traumatic Brain Injury and Co-Injuries Requiring Mechanical Ventilation

Bojan Jovanovic  1 , Zoka Milan, Olivera Djuric, Ljiljana Markovic-Denic, Aleksandar Karamarkovic, Pavle Gregoric, Krstina Doklestic, Jovana Avramovic, Jelena Velickovic, Vesna Bumbasirevic
Affiliations

Twenty-Eight-Day Mortality of Blunt Traumatic Brain Injury and Co-Injuries Requiring Mechanical Ventilation

Bojan Jovanovic et al. Med Princ Pract. 2016.

Abstract

Objective: This paper aims to assess the impact of co-injuries and consequent emergency surgical interventions and nosocomial pneumonia on the 28-day mortality of patients with severe traumatic brain injuries (TBIs).

Subjects and methods: One hundred and seventy-seven patients with TBI admitted to the emergency trauma intensive care unit at the Clinical Center of Serbia for more than 48 h were studied over a 1-year period. On admission, the Glasgow Coma Scale (GCS), Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation II score (APACHE II) were calculated. At admission, an isolated TBI was recorded in 45 of the patients, while 44 had three or more co-injuries.

Results: Of the 177 patients, 78 (44.1%) died by the end of the 28-day follow-up period. They had a significantly higher ISS score (25 vs. 20; p = 0.024) and more severe head (p = 0.034) and chest (p = 0.013) injuries compared to those who survived. Nonsurvivors had spent more days on mechanical ventilation (9.5 vs. 8; p = 0.041) and had a significantly higher incidence of ventilator-associated pneumonia (VAP) than survivors (67.9 vs. 40.4%; p < 0.001). A high Rotterdam CT score (OR 2.062; p < 0.001) and a high APACHE II score (OR 1.219; p < 0.001) were identified as independent predictors of early TBI-related mortality.

Conclusion: Patients who had TBI with a high Rotterdam score and a high APACHE II score were at higher risk of 28-day mortality. VAP was a very common complication of TBI and was associated with an early death and higher mortality in the subgroup of patients with a GCS ≤8.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Mortality rates according to the presence of VAP and GCS category.
Fig. 2
Fig. 2
Mortality rates according to the presence of VAP and APACHE II score category.
See this image and copyright information in PMC

References

    1. Kristiansen T, Lossius HM, Rehn M. Epidemiology of trauma: a population-based study of geographical risk factors for injury deaths in the working-age population of Norway. Injury. 2014;45:23–30. - PubMed
    1. McGarry LJ, Thompson D, Millham FH, et al. Outcomes and costs of acute treatment of traumatic brain injury. J Trauma. 2002;53:1152–1159. - PubMed
    1. Masson F, Thicoipe M, Aye P, et al. Epidemiology of severe brain injuries: a prospective population-based study. J Trauma. 2001;51:481–489. - PubMed
    1. Roozenbeek B, Maas AI, Menon DK. Changing patterns in the epidemiology of traumatic brain injury. Nat Rev Neurol. 2013;9:231–236. - PubMed
    1. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7:728–741. - PubMed