Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome
Background: Medical complications after severe traumatic brain injury (S-TBI) may delay or prevent transfer to rehabilitation units and impact on long-term outcome. Objective: Mapping of medical complications in the subacute period after S-TBI and the impact of these complications on 1-year outcome...
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Uppsala universitet, Rehabiliteringsmedicin
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ftuppsalauniv:oai:DiVA.org:uu-256556 2023-09-26T15:19:23+02:00 Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome Godbolt, Alison K. Stenberg, Maud Jakobsson, Jan Sorjonen, Kimmo Krakau, Karolina Stalnacke, Britt-Marie DeBoussard, Catharina Nygren 2015 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-256556 https://doi.org/10.1136/bmjopen-2014-007208 eng eng Uppsala universitet, Rehabiliteringsmedicin BMJ Open, 2015, 5:4, http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-256556 doi:10.1136/bmjopen-2014-007208 PMID 25941181 ISI:000354705000065 info:eu-repo/semantics/openAccess Neurosciences Neurovetenskaper Article in journal info:eu-repo/semantics/article text 2015 ftuppsalauniv https://doi.org/10.1136/bmjopen-2014-007208 2023-08-30T22:32:08Z Background: Medical complications after severe traumatic brain injury (S-TBI) may delay or prevent transfer to rehabilitation units and impact on long-term outcome. Objective: Mapping of medical complications in the subacute period after S-TBI and the impact of these complications on 1-year outcome to inform healthcare planning and discussion of prognosis with relatives. Setting: Prospective multicentre observational study. Recruitment from 6 neurosurgical centres in Sweden and Iceland. Participants and assessments: Patients aged 18-65 years with S-TBI and acute Glasgow Coma Scale 3-8, who were admitted to neurointensive care. Assessment of medical complications 3 weeks and 3 months after injury. Follow-up to 1 year. 114 patients recruited with follow-up at 1 year as follows: 100 assessed, 7 dead and 7 dropped out. Outcome measure: Glasgow Outcome Scale Extended. Results: 68 patients had >= 1 complication 3 weeks after injury. 3 weeks after injury, factors associated with unfavourable outcome at 1 year were: tracheostomy, assisted ventilation, on-going infection, epilepsy and nutrition via nasogastric tube or percutaneous endoscopic gastroscopy (PEG) tube (univariate logistic regression analyses). Multivariate analysis demonstrated that tracheostomy and epilepsy retained significance even after incorporating acute injury severity into the model. 3 months after injury, factors associated with unfavourable outcome were tracheostomy and heterotopic ossification (Fisher's test), infection, hydrocephalus, autonomic instability, PEG feeding and weight loss (univariate logistic regression). PEG feeding and weight loss at 3 months were retained in a multivariate model. Conclusions: Subacute complications occurred in two-thirds of patients. Presence of a tracheostomy or epilepsy at 3 weeks, and of PEG feeding and weight loss at 3 months, had robust associations with unfavourable outcome that were incompletely explained by acute injury severity. Article in Journal/Newspaper Iceland Uppsala University: Publications (DiVA) BMJ Open 5 4 e007208 e007208 |
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Uppsala University: Publications (DiVA) |
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ftuppsalauniv |
language |
English |
topic |
Neurosciences Neurovetenskaper |
spellingShingle |
Neurosciences Neurovetenskaper Godbolt, Alison K. Stenberg, Maud Jakobsson, Jan Sorjonen, Kimmo Krakau, Karolina Stalnacke, Britt-Marie DeBoussard, Catharina Nygren Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
topic_facet |
Neurosciences Neurovetenskaper |
description |
Background: Medical complications after severe traumatic brain injury (S-TBI) may delay or prevent transfer to rehabilitation units and impact on long-term outcome. Objective: Mapping of medical complications in the subacute period after S-TBI and the impact of these complications on 1-year outcome to inform healthcare planning and discussion of prognosis with relatives. Setting: Prospective multicentre observational study. Recruitment from 6 neurosurgical centres in Sweden and Iceland. Participants and assessments: Patients aged 18-65 years with S-TBI and acute Glasgow Coma Scale 3-8, who were admitted to neurointensive care. Assessment of medical complications 3 weeks and 3 months after injury. Follow-up to 1 year. 114 patients recruited with follow-up at 1 year as follows: 100 assessed, 7 dead and 7 dropped out. Outcome measure: Glasgow Outcome Scale Extended. Results: 68 patients had >= 1 complication 3 weeks after injury. 3 weeks after injury, factors associated with unfavourable outcome at 1 year were: tracheostomy, assisted ventilation, on-going infection, epilepsy and nutrition via nasogastric tube or percutaneous endoscopic gastroscopy (PEG) tube (univariate logistic regression analyses). Multivariate analysis demonstrated that tracheostomy and epilepsy retained significance even after incorporating acute injury severity into the model. 3 months after injury, factors associated with unfavourable outcome were tracheostomy and heterotopic ossification (Fisher's test), infection, hydrocephalus, autonomic instability, PEG feeding and weight loss (univariate logistic regression). PEG feeding and weight loss at 3 months were retained in a multivariate model. Conclusions: Subacute complications occurred in two-thirds of patients. Presence of a tracheostomy or epilepsy at 3 weeks, and of PEG feeding and weight loss at 3 months, had robust associations with unfavourable outcome that were incompletely explained by acute injury severity. |
format |
Article in Journal/Newspaper |
author |
Godbolt, Alison K. Stenberg, Maud Jakobsson, Jan Sorjonen, Kimmo Krakau, Karolina Stalnacke, Britt-Marie DeBoussard, Catharina Nygren |
author_facet |
Godbolt, Alison K. Stenberg, Maud Jakobsson, Jan Sorjonen, Kimmo Krakau, Karolina Stalnacke, Britt-Marie DeBoussard, Catharina Nygren |
author_sort |
Godbolt, Alison K. |
title |
Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
title_short |
Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
title_full |
Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
title_fullStr |
Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
title_full_unstemmed |
Subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
title_sort |
subacute complications during recovery from severe traumatic brain injury : frequency and associations with outcome |
publisher |
Uppsala universitet, Rehabiliteringsmedicin |
publishDate |
2015 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-256556 https://doi.org/10.1136/bmjopen-2014-007208 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
BMJ Open, 2015, 5:4, http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-256556 doi:10.1136/bmjopen-2014-007208 PMID 25941181 ISI:000354705000065 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1136/bmjopen-2014-007208 |
container_title |
BMJ Open |
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5 |
container_issue |
4 |
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e007208 |
op_container_end_page |
e007208 |
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