title: Risk factors for reduced survival after traumatic brain injury: a 30-year follow-up study.
abstract: OBJECTIVE
  To evaluate risk factors for reduced survival in subjects with traumatic brain injury (TBI).
  
  
  METHODS
  A retrospective follow-up of three decades included 192 subjects with TBI. Cognitive testing was carried out on average 2 years after the injury (at mean age of 39.0 years), during the years 1966-1972. Cox's regression and logistic regression analyses were used and the survival of the subjects was compared with the general population using the standardized mortality ratio (SMR).
  
  
  RESULTS
  Reduced survival was significantly associated with age at injury (p < 0.001) and vocational outcome (p = 0.003). Vocational outcome in turn was associated with age (p = 0.010), TBI severity (p < 0.001), cognitive impairment (p = 0.010), later TBIs (p = 0.007) and alcohol abuse (p = 0.015). Mortality in the younger patient group (age at death <40 years) was higher than in the general population (SMR 4.50, 95% CI = 2.02-10.01).
  
  
  CONCLUSIONS
  A reduced working ability, influenced by age-, injury- and lifestyle-related factors, is associated with long-term survival after TBI. The mortality among younger patients is high, a finding which should be considered when planning the care after TBI.
authors.affiliation: Department of Neurology, Turku University Hospital, Turku, Finland. ls.himanen@pp1.inet.fi
authors.forename: Leena
authors.initials: L
authors.lastname: Himanen
authors.forename: Raija
authors.initials: R
authors.lastname: Portin
authors.forename: Päivi
authors.initials: P
authors.lastname: Hämäläinen
authors.forename: Saija
authors.initials: S
authors.lastname: Hurme
authors.forename: Heli
authors.initials: H
authors.lastname: Hiekkanen
authors.forename: Olli
authors.initials: O
authors.lastname: Tenovuo
mesh_terms: D000328:Adult; D017677:Age Distribution; D001930:Brain Injuries / Q000150:complications / Q000401:mortality*; D003072:Cognition Disorders / Q000209:etiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015599:Trauma Severity Indices