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External causes of death after severe traumatic brain injury in a multicentre inception cohort: clinical description and risk factors.
Gates, Thomas M; Baguley, Ian J; Nott, Melissa T; Simpson, Grahame K.
Afiliación
  • Gates TM; a Liverpool Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , New South Wales , Australia.
  • Baguley IJ; b Brain Injury Rehabilitation Service , Westmead Hospital , Sydney , New South Wales , Australia.
  • Nott MT; c School of Community Health , Charles Sturt University , Albury , New South Wales , Australia.
  • Simpson GK; a Liverpool Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , New South Wales , Australia.
Brain Inj ; 33(7): 821-829, 2019.
Article en En | MEDLINE | ID: mdl-30958696
Objective: To characterize the clinical profile of patients dying from external causes (EC) following severe traumatic brain injury (TBI). Design and Methods: Data from 2545 patients forming the NSW-BIRP inception cohort discharged from post-acute inpatient rehabilitation between 1 July 1990 and 1 October 2007 were retrospectively reviewed. Standardized mortality ratios (SMRs) were calculated for EC sub-categories. Demographic, clinical and rehabilitation service factors were compared between deaths from EC, deaths from other causes (OC), and non-deceased. Clinical profiles of EC sub-categories were analysed descriptively. Results: Overall, patients with TBI were 5.2x more likely to die from EC relative to the general population. Risk of death was elevated in all EC sub-categories examined, with the largest risks relating to other accidental threats to breathing (SMR = 33.0; 95%CI = 13.79-60.45) and falls (SMR = 14.3; 95%CI = 5.01-28.39). The EC group were younger, more likely to have pre-injury psychiatric histories, less severe injuries, greater functional independence, and die earlier than the OC group. There was considerable heterogeneity in the clinical profiles of patients dying from different EC sub-categories. Conclusions: EC constitutes one of the largest causes of mortality following TBI in patients surviving beyond the post-acute phase. Potential implications for risk modification and prevention of premature and avoidable deaths are discussed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Suicidio / Accidentes por Caídas / Lesiones Traumáticas del Encéfalo Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Brain Inj Asunto de la revista: CEREBRO Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Suicidio / Accidentes por Caídas / Lesiones Traumáticas del Encéfalo Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: Brain Inj Asunto de la revista: CEREBRO Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido