Abstract
Abstract
Purpose
Traumatic brain injury (TBI) continues to be a significant cause of mortality and morbidity worldwide. As cardiovascular events are among the most common extracranial causes of death after a severe TBI, the Revised Cardiac Risk Index (RCRI) could potentially aid in the risk stratification of this patient population. This investigation aimed to determine the association between the RCRI and in-hospital deaths among isolated severe TBI patients.
Methods
All adult patients registered in the TQIP database between 2013 and 2017 who suffered an isolated severe TBI, defined as a head AIS ≥ 3 with an AIS ≤ 1 in all other body regions, were included. Patients were excluded if they had a head AIS of 6. The association between different RCRI scores (0, 1, 2, 3, ≥ 4) and in-hospital mortality was analyzed using a Poisson regression model with robust standard errors while adjusting for potential confounders, with RCRI 0 as the reference.
Results
259,399 patients met the study’s inclusion criteria. RCRI 2 was associated with a 6% increase in mortality risk [adjusted IRR (95% CI) 1.06 (1.01–1.12), p = 0.027], RCRI 3 was associated with a 17% increased risk of mortality [adjusted IRR (95% CI) 1.17 (1.05–1.31), p = 0.004], and RCRI ≥ 4 was associated with a 46% increased risk of in-hospital mortality [adjusted IRR(95% CI) 1.46 (1.11–1.90), p = 0.006], compared to RCRI 0.
Conclusion
An elevated RCRI ≥ 2 is significantly associated with an increased risk of in-hospital mortality among patients with an isolated severe traumatic brain injury. The simplicity and bedside applicability of the index makes it an attractive choice for risk stratification in this patient population.
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine,Orthopedics and Sports Medicine,Emergency Medicine,Surgery
Reference52 articles.
1. Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017;16:987–1048.
2. Corrigan JD, Selassie AW, Orman JA. The epidemiology of traumatic brain injury. J Head Trauma Rehabil. 2010;25:72–80.
3. Faul M, Coronado V. Chapter 1 - Epidemiology of traumatic brain injury. In: Grafman J, Salazar AM, editors. Handbook of Clinical Neurology [Internet]. Elsevier; 2015. p. 3–13. Available from: https://www.sciencedirect.com/science/article/pii/B9780444528926000015. Accessed 17 Sep 2021
4. Centers for Disease Control and Prevention. Surveillance Report of Traumatic Brain Injury-related Hospitalizations and Deaths by Age Group, Sex, and Mechanism of Injury [Internet]. United States: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2021. Report No.: 2016 and 2017. Available from: https://www.cdc.gov/traumaticbraininjury/pdf/TBI-surveillance-report-2016-2017-508.pdf. Accessed 17 Sept 2021
5. QuickStats: Injury and Traumatic Brain Injury (TBI)-Related Death Rates, by Age Group—United States, 2006* [Internet]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5910a9.html. Accessed 17 Sep 2021
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