Long-term mortality trends in functionally-dependent adults following severe traumatic-brain injury.
OBJECTIVE
To investigate mortality trends in functionally dependent adults following traumatic brain injury (TBI).


METHODS
Data for 966 consecutive admissions to a specialist TBI rehabilitation service were reviewed. Details for 69 subjects who were functionally dependent at rehabilitation discharge were cross-referenced against the State Government Death Register. The observed mortality rate was compared to an equivalent population sample derived from Australian Life Tables.


RESULTS
Twenty-five subjects (36%) were deceased at an average 10.5 years post-injury (SD 5 years; range 1.7-18.8 years). The observed numbers of deaths far exceeded the expected population figure (1.9) for the same period (1989-2007) yielding a standardized mortality rate of 13.2. Mortality trends suggested a bimodal distribution, with more deaths in the first 5 years post-injury followed by no further deaths until 9 years post-injury.


CONCLUSIONS
Mortality in this functionally-dependent group was significantly associated with age, male sex and degree of disability at discharge. The bimodal distribution of mortality data suggests different contributory mechanisms to early vs. late mortality in this group.
Baguley
Ian J
IJ
Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, Australia. ianb@biru.wsahs.nsw.gov.au
Nott
Melissa T
MT
Slewa-Younan
Shameran
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001930:Brain Injuries / Q000401:mortality*; D002423:Cause of Death; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011788:Quality of Life; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult