Outcomes after Traumatic Brain Injury with Concomitant Severe Extracranial Injuries
Open accessAbstract
Traumatic brain injury (TBI) is a leading cause of death and disability in trauma patients. Patients with TBI frequently sustain concomitant injuries in extracranial regions. The effect of severe extracranial injury (SEI) on the outcome of TBI is controversial. For 8 years, we retrospectively enrolled 485 patients with the blunt head injury with head abbreviated injury scale (AIS) ≧ 3. SEI was defined as AIS ≧ 3 injuries in the face, chest, abdomen, and pelvis/extremities. Vital signs and coagulation parameter values were also extracted from the database. Total patients were dichotomized into isolated TBI (n = 343) and TBI associated with SEI (n = 142). The differences in severity and outcome between these two groups were analyzed. To assess the relation between outcome and any variables showing significant differences in univariate analysis, we included the parameters in univariable and multivariable logistic regression analyses. Mortality was 17.8% in the isolated TBI group and 21.8% in TBI with SEI group (P = 0.38), but the Glasgow Outcome Scale (GOS) in the TBI with SEI group was unfavorable compared to the isolated TBI group (P = 0.002). Patients with SBP ≦ 90 mmHg were frequent in the TBI with SEI group. Adjusting for age, GCS, and length of hospital stay, SEI was a strong prognostic factor for mortality with adjusted ORs of 2.30. Hypotension and coagulopathy caused by SEI are considerable factors underlying the secondary insults to TBI. It is important to manage not only the brain but the whole body in the treatment of TBI patients with SEI.
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Because comorbidities and extracranial injuries might have different prevalence in men versus women, the absence of widespread reporting of these factors is an important limitation in interpreting findings of sex differences.
“Because comorbidities and extracranial injuries might have different prevalence in men versus women, 33,35 the absence of widespread reporting of these factors is an important limitation in interpreting findings of sex differences.”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [33]
Comorbidities and extracerebral injuries can affect the clinical course and outcomes of TBI.
“Comorbidities and extracerebral injuries can affect the clinical course and outcomes of TBI. 33,34”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [33]
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Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know
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- Authors
- WATANABE, T., KAWAI, Y., IWAMURA, A., MAEGAWA, N., FUKUSHIMA, H., & OKUCHI, K.
- Affiliations
- Nara Medical University (JP)
- Corresponding author
- OKUCHI, Kazuo
- Venue
- Neurologia medico-chirurgica
- Publisher
- Japan Neurosurgical Society
- Published
- 2018
- Volume
- 58
- Issue
- 9
- Pages
- 393-399
- ISSN
- 0470-8105 (ISSN-L)
- 1349-8029
- PMC
- PMC6156128
- OpenAlex
- W2887742392
- Cited by
- 52
- References
- 21
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 9 · 2023: 2 · 2022: 8 · 2021: 9 · 2020: 7 · 2019: 2 · 2018: 1
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Neurologia medico-chirurgica (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Kindai University
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- traumatic brain injury, polytrauma, extracranial injuries, blunt head trauma, mortality, Glasgow Outcome Scale, prognostic factors, hypotension, coagulopathy, secondary brain injury, Abbreviated Injury Scale
- MeSH terms
- Brain Injuries, Traumatic, Adult, Aged, Female, Humans, Male, Middle Aged, Multiple Trauma, Prognosis, Retrospective Studies, Wounds, Nonpenetrating, Abbreviated Injury Scale, Logistic Models, Glasgow Outcome Scale
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