Research Reports - Long-term survival after traumatic brain injury

J Head Trauma Rehabil. 2013 Feb 1

Brown AW, Leibson CL, Mandrekar J, Ransom JE, Malec JF

OBJECTIVE:: To examine the contribution of cooccurring nonhead injuries to hazard
of death after traumatic brain injury (TBI). PARTICIPANTS:: A random sample of
Olmsted County, Minnesota, residents with confirmed TBI from 1987 through 1999
was identified. DESIGN:: Each case was assigned an age- and sex-matched, non-TBI
"regular control" from the population. For "special cases" with accompanying
nonhead injuries, 2 matched "special controls" with nonhead injuries of similar
severity were assigned. MEASURES:: Vital status was followed from baseline (ie,
injury date for cases, comparable dates for controls) through 2008. Cases were
compared first with regular controls and second with regular or special controls,
depending on case type. RESULTS:: In total, 1257 cases were identified (including
221 special cases). For both cases versus regular controls and cases versus
regular or special controls, the hazard ratio was increased from baseline to 6
months (10.82 [2.86-40.89] and 7.13 [3.10-16.39], respectively) and from baseline
through study end (2.92 [1.74-4.91] and 1.48 [1.09-2.02], respectively). Among
6-month survivors, the hazard ratio was increased for cases versus regular
controls (1.43 [1.06-2.15]) but not for cases versus regular or special controls
(1.05 [0.80-1.38]). CONCLUSIONS:: Among 6-month survivors, accounting for nonhead
injuries resulted in a nonsignificant effect of TBI on long-term mortality.

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