Abstract：
The lack of objective prognostication tools for severe traumatic brain injury (TBI) causes variability in the application of withdrawal of life-saving treatment (WLST). We aimed to determine whether WLST in persons with severe TBI is associated with known indicators of poor prognosis.
This retrospective descriptive study focused on adult (18-64 years) and geriatric (≥65 years) patients with severe TBI who were admitted between August 1, 2018 and July 31, 2021 at a Level I trauma center and subsequently underwent WLST. The data collected from the Trauma Registry and electronic health records included information regarding demographic characteristics, injury severity, clinical variables, and length of hospital stay and were used to examine the indicators of poor prognosis and WLST.
Among the 164 participants with TBI who met the inclusion criteria, 61.0% were geriatric, and 122 (74.4%) patients had 0 or only 1 of the poor prognostic indicators prior to WLST. The non-geriatric group had more indicators of poor prognosis than the geriatric group. Participants with fewer indicators of poor prognosis had a longer length-of-stay.
In severe TBI cases, standardized prognostication tools can help guide informed WLST decisions, particularly in geriatric patients, improving care consistency.
This retrospective descriptive study focused on adult (18-64 years) and geriatric (≥65 years) patients with severe TBI who were admitted between August 1, 2018 and July 31, 2021 at a Level I trauma center and subsequently underwent WLST. The data collected from the Trauma Registry and electronic health records included information regarding demographic characteristics, injury severity, clinical variables, and length of hospital stay and were used to examine the indicators of poor prognosis and WLST.
Among the 164 participants with TBI who met the inclusion criteria, 61.0% were geriatric, and 122 (74.4%) patients had 0 or only 1 of the poor prognostic indicators prior to WLST. The non-geriatric group had more indicators of poor prognosis than the geriatric group. Participants with fewer indicators of poor prognosis had a longer length-of-stay.
In severe TBI cases, standardized prognostication tools can help guide informed WLST decisions, particularly in geriatric patients, improving care consistency.
摘要：
■缺乏用于严重创伤性脑损伤（TBI）的客观预测工具，导致在撤回救生治疗（WLST）的应用中存在差异。我们旨在确定严重TBI患者的WLST是否与已知的不良预后指标相关。
这项回顾性描述性研究的重点是成人（18-64岁）和老年（≥65岁）严重TBI患者，他们在2018年8月1日至2021年7月31日期间在I级创伤中心入院，随后接受了WLST。从创伤登记处和电子健康记录收集的数据包括有关人口统计学特征的信息，损伤严重程度,临床变量，和住院时间，并用于检查不良预后和WLST的指标。
■在164名符合入选标准的TBI参与者中，61.0%是老年人，122例(74.4%)患者在WLST之前有0项或只有1项不良预后指标.非老年病组比老年病组有更多的不良预后指标。预后不良指标较少的参与者的住院时间较长。
■在严重的TBI病例中，标准化的预测工具可以帮助指导明智的WLST决策，特别是在老年患者中，提高护理的一致性。
这项回顾性描述性研究的重点是成人（18-64岁）和老年（≥65岁）严重TBI患者，他们在2018年8月1日至2021年7月31日期间在I级创伤中心入院，随后接受了WLST。从创伤登记处和电子健康记录收集的数据包括有关人口统计学特征的信息，损伤严重程度,临床变量，和住院时间，并用于检查不良预后和WLST的指标。
■在164名符合入选标准的TBI参与者中，61.0%是老年人，122例(74.4%)患者在WLST之前有0项或只有1项不良预后指标.非老年病组比老年病组有更多的不良预后指标。预后不良指标较少的参与者的住院时间较长。
■在严重的TBI病例中，标准化的预测工具可以帮助指导明智的WLST决策，特别是在老年患者中，提高护理的一致性。
