Predicting Factors Associated with In-hospital Mortality in Traumatic Brain Injury.

Abstract

Introduction: The accurate identification of predictors of mortality is of utmost importance in risk stratification, as it empowers health care teams to efficiently allocate resources and interventions to patients who are at a higher risk. Our objective was to investigate the factors linked to in-hospital mortality in patients who have suffered a traumatic brain injury (TBI).

Materials and methods: This study employed a retrospective design, utilizing data from the National Trauma Registry of Iran spanning September 17, 2016, to July 31, 2022. The study included TBI patients admitted to participating hospitals with a hospital stay exceeding 24 hours, those who died during hospitalization, or those transferred from other facilities. TBI cases were identified using specific International Classification of Diseases, Tenth Revision codes. The study incorporated various variables, including baseline characteristics such as age (categorized into pediatric, adult, and geriatric groups), gender, trauma mechanism, and mode of transportation. Clinical characteristics considered included the Glasgow coma scale (GCS), injury severity score (ISS), types of injuries sustained, interventions performed, and vital signs. The primary outcome was mortality following hospital admission.

Results: The study included 874 patients, and the observed mortality rate was 12.2%. Road traffic crashes were identified as the leading cause of TBI, accounting for 72.5% of the cases. Utilizing multiple logistic regression analysis, the study confirmed that older age, severe GCS score, tracheostomy, and abnormal oxygen saturation were significant predictors of mortality.

Conclusion: The findings of this study demonstrate that older age, lower GCS scores (severe TBI), tracheostomy, and abnormal oxygen saturation are significant predictors of mortality in patients with TBI. These results emphasize the significance of incorporating age, neurological status, and respiratory function into the assessment of prognosis and mortality risk in TBI patients. By considering these factors, health care professionals can better evaluate the potential outcomes and allocate appropriate care for TBI patients.