Severe Traumatic Brain Injury Outcomes In Patients With Premorbid Psychiatric Illness.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-30 DOI:10.1016/j.wneu.2024.10.096

Justin N Passman, Nathaniel A Cleri, Jermaine Robertson, Jordan R Saadon, Claire Polizu, Xuwen Zheng, Vaibhav Vagal, Sima Mofakham, Charles B Mikell

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引用次数: 0

Abstract

Objective: Individuals with psychiatric illnesses (PI) have increased rates of traumatic brain injury (TBI). Nonetheless, the influence of underlying PI on TBI outcomes is poorly understood.

Methods: We analyzed the medical records of 633 adult-severe TBI (sTBI) patients admitted to our institution between 2010-2021. We identified patients with premorbid PI (Psych(+) group, n=129) and a subset with only a substance use disorder (SUD(+) group, n=60) and compared them to patients without PI (Psych(-) group, n=480). Outcome measures included discharge Glasgow Coma Scale (GCS), length of stay (LOS), in-hospital survival, and Glasgow Outcome Scale-Extended (GOS-E).

Results: The Psych(+) group had increased in-hospital survival (69.8% v. 55.0%, P=0.003) and fewer patients with severe (3-8) discharge-GCS (28.7% v. 46.0%, P<0.001). The SUD(+) group had increased in-hospital survival (70.0% v. 55.0%, P=0.028) and fewer patients with severe discharge-GCS (28.3% v. 46.0%, P=0.009). However, the Psych(+) (21.0 v. 10.0 days, P<0.001) and SUD(+) (16.0 v. 10.0 days, P=0.011) groups had longer LOS. The Psych(+) group had a higher mean GOS-E at discharge (2.7 v. 2.4, P=0.004), six-months (3.8 v. 3.0, P=0.006) and one-year (3.4 v. 2.3, P=0.027). The SUD(+) group also had a higher mean GOS-E at discharge (2.8 v. 2.4, P=0.034), six months (3.8 v. 3.0, P=0.035), and one year (3.5 v. 2.3, P=0.008). Additionally, there were no significant differences in injury severity or CT scan findings.

Conclusions: Individuals with PI and SUD appeared to have better outcomes but more complicated hospital stays following sTBI. Future studies should investigate the mechanisms underlying these outcomes.

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先心病患者的严重脑外伤疗效。

目的：患有精神疾病（PI）的人发生创伤性脑损伤（TBI）的几率更高。然而，人们对潜在精神疾病对创伤性脑损伤结果的影响知之甚少：我们分析了本院在 2010-2021 年间收治的 633 名成年重度 TBI（sTBI）患者的病历。我们确定了有病前 PI 的患者（Psych(+)组，n=129）和仅有药物使用障碍的患者（SUD(+)组，n=60），并将他们与无 PI 的患者（Psych(-)组，n=480）进行了比较。结果测量包括出院时的格拉斯哥昏迷量表（GCS）、住院时间（LOS）、院内存活率和格拉斯哥结果量表扩展版（GOS-E）：结果：Psych(+)组的院内存活率更高（69.8% 对 55.0%，P=0.003），出院 GCS 重度（3-8）患者更少（28.7% 对 46.0%，P=0.003）：有 PI 和 SUD 的患者在 sTBI 后似乎有更好的预后，但住院时间更长。未来的研究应调查这些结果的内在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.