title: Potential risk factors for developing heterotopic ossification in patients with severe traumatic brain injury.
abstract: BACKGROUND
  Heterotopic ossification (HO) is a frequent complication after traumatic brain injury (TBI). The current preliminary study is intended to provide additional data on the potential roles that brain injury severity, concomitant orthopaedic trauma, and specific intensive care complicating events may play in the prediction of HO in patients who have sustained severe TBI.
  
  
  METHODS
  A prospective cohort study in patients with severe TBI.
  
  
  RESULTS
  Ninety-seven of the 176 patients were eligible for follow-up; 13 patients (13%) developed 19 clinically relevant HOs at 1 or more sites. Univariate analysis indicated that patients with HO remained in coma longer (P < .001) and were ventilated during a longer period (P = .002). Autonomic dysregulation (relative risk = 6.11, 95% confidence interval: 2.53-14.76) and surgically treated extremity fractures (relative risk = 5.02, 95% confidence interval: 1.68-15.04) also showed significant associations with the development of HO.
  
  
  CONCLUSIONS
  Prolonged coma duration and mechanical ventilation, coexistent surgically treated bone fractures and clinical signs of autonomic dysregulation should be given further consideration as potential risk factors for developing clinically relevant HO. Larger-scale studies are needed to develop a valid risk profile that takes into account the interrelationships between variables.
authors.affiliation: Rehabilitation Centre Groot Klimmendaal, Arnhem, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: van Kampen
authors.forename: J D
authors.initials: JD
authors.lastname: Martina
authors.forename: P E
authors.initials: PE
authors.lastname: Vos
authors.forename: C W E
authors.initials: CW
authors.lastname: Hoedemaekers
authors.forename: H T
authors.initials: HT
authors.lastname: Hendricks
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D015599:Trauma Severity Indices