Change search
ReferencesLink to record
Permanent link

Direct link
Subacute complications during recovery from severe traumatic brain injury: frequency and associations with outcome
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
Show others and affiliations
2015 (English)In: BMJ Open, ISSN 2044-6055, Vol. 5, no 4, e007208Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2015. Vol. 5, no 4, e007208
National Category
URN: urn:nbn:se:uu:diva-256556DOI: 10.1136/bmjopen-2014-007208ISI: 000354705000065PubMedID: 25941181OAI: diva2:826006
Available from: 2015-06-24 Created: 2015-06-24 Last updated: 2015-06-24Bibliographically approved

Open Access in DiVA

fulltext(817 kB)35 downloads
File information
File name FULLTEXT01.pdfFile size 817 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed
By organisation
Rehabilitation Medicine
In the same journal
BMJ Open

Search outside of DiVA

GoogleGoogle Scholar
Total: 35 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 194 hits
ReferencesLink to record
Permanent link

Direct link