Predictors of postacute mortality following traumatic brain injury in a seriously injured population.
BACKGROUND
Traumatic brain injury (TBI) is a primary cause of injury mortality in developed countries but less is known about the impact of TBI on postacute mortality in large study populations. This study investigates the rate and predictors of postacute mortality (1-9 years after the initial injury) of severely injured persons with TBI in the Province of Ontario from April 1, 1993 to March 31, 1995.


METHODS
Cases were identified (n = 2,721) from the Ontario Trauma Registry Comprehensive Data Set based on lead trauma hospitals in the province which also provided data on predictors. Severely injured patients (n = 557) who had lower extremity injuries during the sample time period formed a control population.


RESULTS
Poisson regression modeling showed that having a TBI was a significant predictor of premature death controlling for age and injury severity. Age, the number of comorbidities, injury severity, mechanism of injury, and discharge destination were significant predictors in the multivariate analyses for the TBI population.


CONCLUSIONS
This research quantifies the elevated risk of premature death in the postacute period for seriously injured adults with TBI and identifies factors most associated with highest mortality rates in this population.
Colantonio
Angela
A
Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada. angela.colantonio@utoronto.ca
Escobar
Michael D
MD
Chipman
Mary
M
McLellan
Barry
B
Austin
Peter C
PC
Mirabella
Giuseppe
G
Ratcliff
Graham
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D016012:Poisson Distribution; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors