Comparison between traumatic brain injury with and without concomitant injuries: an analysis based on a national trauma registry 2008–2016

ABSTRACT

Objective: To compare demographic, injury and hospitalization characteristics and mortality between Isolated and Non-Isolated traumatic brain injury.

Methods: A retrospective study based on the Israeli National Trauma Registry of patients hospitalized for traumatic brain injury (TBI) between 2008 and 2016. Isolated TBI was defined as no other anatomic region was having concomitant injury with AIS ≥2. X² test and multivariate logistic regression analysis were used for data analysis.

Results: Of the 23566-study population, 40.4% were admitted for isolated TBI. Isolated TBI was significantly more frequent in elderly aged ≥65 years, female, Jews, and injuries sustained at home or in residential institution. The Non-isolated TBI was greater in road traffic injuries, particularly among pedestrians and motor cyclists, and in violence injuries. The Non-isolated TBI group had greater injury severity and hospital resource utilization. In-hospital mortality was higher in the patients with Non-isolated TBI [OR: 1.56(95% CI: 1.33–1.83)], particularly in patients with GCS 13–15; elderly aged 65+ years; and patients with concomitant injuries to abdomen, spine or external body regions.

Conclusion: In a patient with TBI, concomitant injuries with AIS ≥2 matter, and awareness of the identified factors has relevance for guiding injury prevention efforts and indeed for potentially improving care and outcome.

KEYWORDS:

• Traumatic brain injury
• concomitant injuries
• hospitalization
• mortality
• National Trauma Registry

Acknowledgments

The authors wish to thank the Israel Trauma Group for their responsibility for the data completing. The Trauma Group includes H. Bahouth, A. Becker, A. Hadary, I. Jeroukhimov, M. Karawani, B. Kessel, Y. Klein, G. Lin, O. Merin, B. Miklush, Y. Mnouskin, A. Rivkind, G. Shaked, G. Sibak, D. Soffer, M. Stein, M. Wais, H. Pharan and I. Garbetzev. The authors would also like to thank Sharon Goldman for the English proofreading and corrections.

Authors’ contributions

AT and MST conceived and designed the study, analyzed the data and wrote the manuscript. AG analyzed the data and reviewed the manuscript. KP conceived and designed the study, reviewed and revised the manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

Not applicable.

Declaration Section

Ethics approval and consent to participate: The research received the approval of the Sheba Medical Center’s Institutional Review Board 5138-18-SMC. The research is based on anonymous registry, there for consent to participant was not mandatory.

Availability of data and material: The datasets generated and analyzed during the current study are not publicly available due hospitalization privacy but are available from the corresponding author on reasonable request.

Financial Disclosure

The authors have no financial relationships relevant to this article to disclose.

Potential Conflicts of Interest

The authors have no conflicts of interest relevant to this article to disclose.

Additional information

Funding

None