Mechanism of injury predicts outcome in traumatic brain injury

Document Type

Article

Department

General Surgery

Abstract

Objective: To determine the independent effect of Mechanism of Injury (MOI) on risk-adjusted survival in Traumatic Brain Injury (TBI).
Methods: Patient Population; TBI hospital discharges (N=178,642 identified by ICD-9 head injury diagnosis codes) in the 1991-2001 New York Statewide Planning and Research Cooperative System (SPARCS) dataset. MOI was determined by ICD-9 E-Codes. TBI severity was categorized by the Relative Head Injury Severity Score (RHISS). Statistical Analysis: Stepwise logistic regression was used to predict mortality based on: age, gender, ICD-9 injury severity score (ICISS), RHISS, insurance status and MOI.
Results: 10,786 (6.1%) TBI patients died. Area under the Receiver Operating Characteristic Curve for mortality prediction was 0.93. MOI was an independently significant predictor (p<.001). The table shows Odds Ratios (OR) for death for each MOI, with motor vehicle crash (MVC) as the reference group (OR= 1). Relative to MVC, all MOIs except bicycle crashes and sports related injuries were associated with a significantly higher probability of death. Gunshots and Burns were associated with the highest odds of death relative to MVC.
Conclusion: Mechanism of injury plays a role in determining the outcome of traumatic brain injury that is independent of injury severity and demographic factors. Greater understanding of mechanism-related prognostic factors may lead to improved outcomes and help guide preventative measures

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

Journal of Surgical Research

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