Research Reports - Complications following hospital admission for traumatic brain injury

J Crit Care. 2017 Apr 27;41:1-8. doi: 10.1016/j.jcrc.2017.04.031. [Epub ahead of
print]

Omar M(1), Moore L(2), Lauzier F(3), Tardif PA(1), Dufresne P(1), Boutin A(1),
Lessard-Bonaventure P(4), Paquet J(5), Clément J(6), Turgeon AF(7).

PURPOSE: To evaluate the incidence, determinants and impact on outcome of
in-hospital complications in adults with traumatic brain injury (TBI).
MATERIALS AND METHODS: We conducted a multicenter cohort study of TBI patients
admitted between 2007 and 2012 in an inclusive Canadian trauma system. Risk
ratios of complications, odds ratios of mortality and geometric mean ratios of
length of stay (LOS) were calculated using generalized linear models with
adjustment for prognostic indicators and hospital cluster effects.
RESULTS: Of 12,887 patients, 3.2% had at least one neurological complication and
22.6% a non-neurological complication. Mechanical ventilation, head injury
severity, blood transfusion and neurosurgical intervention had the strongest
correlation with neurological complications. Mechanical ventilation, the Glasgow
Coma Scale, blood transfusion and concomitant injuries had the strongest
correlation with non-neurological complications. Neurological and
non-neurological complications were associated with a 85% and 53% increase in the
odds of mortality, and a 60% and two-fold increases in LOS, respectively.
CONCLUSIONS: More than 20% of patients with TBI developed a complication. Many of
these complications were associated with increased mortality and LOS. Results
highlight the importance of prevention strategies adapted to treatment decisions
and underline the need to improve knowledge on the underuse and overuse of
clinical interventions. 

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