Highlights
- •Dynamic factors affect mortality in ICU patients with traumatic brain injury (TBI).
- •Protective ICU factors post-TBI include certain medications and blood products.
- •Long-term post-TBI mortality is influenced by socioeconomic factors.
Abstract
Background
Mortality risks after Traumatic Brain Injury (TBI) are understudied in critical illness.
We sought to identify risks of mortality in critically ill patients with TBI using
time-varying covariates.
Methods
This single-center, six-year (2006–2012), retrospective cohort study measured demographics,
injury characteristics, and daily data of acute TBI patients in the Intensive Care
Unit (ICU). Time-varying Cox proportional hazards models assessed in-hospital and
3-year mortality.
Results
Post-TBI ICU patients (n = 2664) experienced 20% in-hospital mortality (n = 529) and
27% (n = 706) 3-year mortality. Glasgow Coma Scale motor subscore (hazard ratio (HR)
0.58, p < 0.001), pupil reactivity (HR 3.17, p < 0.001), minimum glucose (HR 1.44,
p < 0.001), mSOFA score (HR 1.81, p < 0.001), coma (HR 2.26, p < 0.001), and benzodiazepines
(HR 1.38, p < 0.001) were associated with in-hospital mortality. At three years, public
insurance (HR 1.78, p = 0.011) and discharge disposition (HR 4.48, p < 0.001) were
associated with death.
Conclusions
Time-varying characteristics influenced in-hospital mortality post-TBI. Socioeconomic
factors primarily affect three-year mortality.
Keywords
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Article info
Publication history
Published online: October 27, 2022
Accepted:
October 5,
2022
Received in revised form:
September 27,
2022
Received:
August 11,
2022
Identification
Copyright
Published by Elsevier Inc.
