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Abstract：
UNASSIGNED:
UNASSIGNED: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.
UNASSIGNED: Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury.
UNASSIGNED: Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.
UNASSIGNED: After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed.
UNASSIGNED: IV.
UNASSIGNED: NCT02119182.
UNASSIGNED: An estimated 14-23% of patients with traumatic brain injury (TBI) incur multiple lifetime TBIs. The relationship between prior TBI and outcomes in patients with moderate to severe TBI (msTBI) is not well delineated. We examined the associations between prior TBI, in-hospital mortality, and outcomes up to 12 months after injury in a prospective US msTBI cohort.
UNASSIGNED: Data from hospitalized subjects with Glasgow Coma Scale score of 3-12 were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (enrollment period: 2014-2019). Prior TBI with amnesia or alteration of consciousness was assessed using the Ohio State University TBI Identification Method. Competing risk regressions adjusting for age, sex, psychiatric history, cranial injury and extracranial injury severity examined the associations between prior TBI and in-hospital mortality, with hospital discharged alive as the competing risk. Adjusted HRs (aHR (95% CI)) were reported. Multivariable logistic regressions assessed the associations between prior TBI, mortality, and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-3 (vs. 4-8)) at 3, 6, and 12 months after injury.
UNASSIGNED: Of 405 acute msTBI subjects, 21.5% had prior TBI, which was associated with male sex (87.4% vs. 77.0%, p=0.037) and psychiatric history (34.5% vs. 20.7%, p=0.010). In-hospital mortality was 10.1% (prior TBI: 17.2%, no prior TBI: 8.2%, p=0.025). Competing risk regressions indicated that prior TBI was associated with likelihood of in-hospital mortality (aHR=2.06 (1.01-4.22)), but not with hospital discharged alive. Prior TBI was not associated with mortality or unfavorable outcomes at 3, 6, and 12 months.
UNASSIGNED: After acute msTBI, prior TBI history is independently associated with in-hospital mortality but not with mortality or unfavorable outcomes within 12 months after injury. This selective association underscores the importance of collecting standardized prior TBI history data early after acute hospitalization to inform risk stratification. Prospective validation studies are needed.
UNASSIGNED: IV.
UNASSIGNED: NCT02119182.
摘要：
■
■估计有14-23％的创伤性脑损伤（TBI）患者会发生多次终生TBI。先前的TBI与中度至重度TBI（msTBI）患者的预后之间的关系尚未得到很好的描述。我们检查了之前的TBI，住院死亡率，在前瞻性美国msTBI队列中，以及受伤后12个月的结果。
■来自格拉斯哥昏迷量表评分为3-12的住院受试者的数据来自创伤性脑损伤转化研究和临床知识研究（招募期：2014-2019年）。使用俄亥俄州立大学TBI鉴定方法评估患有健忘症或意识改变的先前TBI。竞争风险回归调整年龄，性别,精神病史,颅脑损伤和颅外损伤严重程度检查了既往TBI和院内死亡率之间的关系，活着出院是竞争的风险。报告了调整后的HR（aHR（95%CI））。多变量逻辑回归评估了先前TBI之间的关联，死亡率,和不利的结果(格拉斯哥结果量表-扩展评分1-3(vs.4-8））在受伤后3、6和12个月。
■在405名急性msTBI受试者中，21.5%以前有TBI，与男性相关(87.4%vs.77.0%,p=0.037）和精神病史（34.5%vs.20.7%,p=0.010)。住院死亡率为10.1％（先前的TBI：17.2％，没有先前的TBI：8.2%，p=0.025)。竞争性风险回归表明，先前的TBI与住院死亡率的可能性相关（aHR=2.06（1.01-4.22）），但不能活着出院.既往TBI在3、6和12个月时与死亡率或不利结局无关。
■急性msTBI后，既往TBI病史与院内死亡率独立相关,但与伤后12个月内的死亡率或不良结局无关.这种选择性关联强调了在急性住院后早期收集标准化的TBI病史数据以告知风险分层的重要性。需要进行前瞻性验证研究。
■IV.
■NCT02119182。
■估计有14-23％的创伤性脑损伤（TBI）患者会发生多次终生TBI。先前的TBI与中度至重度TBI（msTBI）患者的预后之间的关系尚未得到很好的描述。我们检查了之前的TBI，住院死亡率，在前瞻性美国msTBI队列中，以及受伤后12个月的结果。
■来自格拉斯哥昏迷量表评分为3-12的住院受试者的数据来自创伤性脑损伤转化研究和临床知识研究（招募期：2014-2019年）。使用俄亥俄州立大学TBI鉴定方法评估患有健忘症或意识改变的先前TBI。竞争风险回归调整年龄，性别,精神病史,颅脑损伤和颅外损伤严重程度检查了既往TBI和院内死亡率之间的关系，活着出院是竞争的风险。报告了调整后的HR（aHR（95%CI））。多变量逻辑回归评估了先前TBI之间的关联，死亡率,和不利的结果(格拉斯哥结果量表-扩展评分1-3(vs.4-8））在受伤后3、6和12个月。
■在405名急性msTBI受试者中，21.5%以前有TBI，与男性相关(87.4%vs.77.0%,p=0.037）和精神病史（34.5%vs.20.7%,p=0.010)。住院死亡率为10.1％（先前的TBI：17.2％，没有先前的TBI：8.2%，p=0.025)。竞争性风险回归表明，先前的TBI与住院死亡率的可能性相关（aHR=2.06（1.01-4.22）），但不能活着出院.既往TBI在3、6和12个月时与死亡率或不利结局无关。
■急性msTBI后，既往TBI病史与院内死亡率独立相关,但与伤后12个月内的死亡率或不良结局无关.这种选择性关联强调了在急性住院后早期收集标准化的TBI病史数据以告知风险分层的重要性。需要进行前瞻性验证研究。
■IV.
■NCT02119182。
