Temporal Trends in Functional Outcomes after Severe Traumatic Brain Injury: 2006-2015

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Severe traumatic brain injury (TBI) is associated with poor outcomes; however, little is known about whether these outcomes are improving over time. This study examined temporal trends in functional outcomes of severe TBI at six months post-injury. We conducted a retrospective cohort study (January 1, 2006 to December 31, 2015) of hospitalized adult (≥16 years) patients with severe TBI using data from the population-based Victorian State Trauma Registry. The primary outcome was the Glasgow Outcome Scale-Extended (GOS-E) at six months post-injury, dichotomized as upper severe disability or worse (GOS-E ≤4, termed "unfavorable outcome") and lower moderate disability or better (GOS-E ≥5; termed "favorable outcome"). Multivariable logistic regression was used to investigate temporal trends in functional outcomes at six months post-injury. Of the 1966 patients with severe TBI who were followed up at six months post-injury (median age, 42 years (interquartile range [IQR]: 25-68); male, 73%), a majority of patients had an unfavorable outcome (GOS-E ≤4; n = 1372, 70%). After adjusting for confounders, there was no change in functional outcomes over time (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI]: 0.98,1.06; p = 0.35). Similarly, there was no change in the adjusted odds of death (GOS-E = 1) at six months post-injury (AOR = 1.04, 95% CI: 1.00,1.08; p = 0.08). Using a population-wide, high quality, comprehensive registry, we demonstrated no change in death or functional outcomes after severe TBI between 2006 and 2015 in a mature trauma system. There is a clear need to identify targeted improvements in the treatment of these patients with the aim of reducing in-hospital death and improving long-term outcomes.

Original languageEnglish
Pages (from-to)1021-1029
Number of pages9
JournalJournal of Neurotrauma
Volume35
Issue number8
DOIs
Publication statusPublished - 15 Apr 2018

Keywords

  • disability
  • epidemiology
  • head injury
  • trauma
  • trends over time

Cite this

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title = "Temporal Trends in Functional Outcomes after Severe Traumatic Brain Injury: 2006-2015",
abstract = "Severe traumatic brain injury (TBI) is associated with poor outcomes; however, little is known about whether these outcomes are improving over time. This study examined temporal trends in functional outcomes of severe TBI at six months post-injury. We conducted a retrospective cohort study (January 1, 2006 to December 31, 2015) of hospitalized adult (≥16 years) patients with severe TBI using data from the population-based Victorian State Trauma Registry. The primary outcome was the Glasgow Outcome Scale-Extended (GOS-E) at six months post-injury, dichotomized as upper severe disability or worse (GOS-E ≤4, termed {"}unfavorable outcome{"}) and lower moderate disability or better (GOS-E ≥5; termed {"}favorable outcome{"}). Multivariable logistic regression was used to investigate temporal trends in functional outcomes at six months post-injury. Of the 1966 patients with severe TBI who were followed up at six months post-injury (median age, 42 years (interquartile range [IQR]: 25-68); male, 73{\%}), a majority of patients had an unfavorable outcome (GOS-E ≤4; n = 1372, 70{\%}). After adjusting for confounders, there was no change in functional outcomes over time (adjusted odds ratio [AOR] = 1.02, 95{\%} confidence interval [CI]: 0.98,1.06; p = 0.35). Similarly, there was no change in the adjusted odds of death (GOS-E = 1) at six months post-injury (AOR = 1.04, 95{\%} CI: 1.00,1.08; p = 0.08). Using a population-wide, high quality, comprehensive registry, we demonstrated no change in death or functional outcomes after severe TBI between 2006 and 2015 in a mature trauma system. There is a clear need to identify targeted improvements in the treatment of these patients with the aim of reducing in-hospital death and improving long-term outcomes.",
keywords = "disability, epidemiology, head injury, trauma, trends over time",
author = "Ben Beck and Dashiell Gantner and Cameron, {Peter A.} and Sandra Braaf and Manoj Saxena and Cooper, {D. James} and Gabbe, {Belinda J.}",
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Temporal Trends in Functional Outcomes after Severe Traumatic Brain Injury : 2006-2015. / Beck, Ben; Gantner, Dashiell; Cameron, Peter A.; Braaf, Sandra; Saxena, Manoj; Cooper, D. James; Gabbe, Belinda J.

In: Journal of Neurotrauma, Vol. 35, No. 8, 15.04.2018, p. 1021-1029.

Research output: Contribution to journalArticleResearchpeer-review

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