Global outcome in acute phase of treatment following moderate-to-severe traumatic brain injury from motor vehicle collisions vs assaults

Abstract

Primary objective: To compare socio-demographic, medical characteristics and acute outcomes between patients with traumatic brain injuries (TBIs) from motor vehicle collision (MVC) or assault in an acute care setting.

Research design: This descriptive, comparative retrospective cohort study included 415 patients with moderate and severe TBI secondary to an assault (n = 91) vs a motor vehicle collision (n = 324).

Methods and procedures: Outcome measures were length of stay (LOS) in the intensive care unit and in hospital, Extended Glasgow Outcome Scale (GOS-E), FIM® instrument (‘FIM’) and discharge destination.

Main outcomes and results: Patients with TBI from MVC had a higher percentage of polytrauma, higher injury severity scores, required more orthopaedic surgeries and thoracic drain insertions. Patients with TBI from assault were more often non-Caucasian, young single men, less educated with higher unemployment rates and criminal records, with a history of alcohol and drug abuse and were more often intoxicated on admission. There was no significant group difference in the LOS and FIM ratings, but patients with assault-related TBI were more often discharged home and had a more favourable GOS-E.

Conclusion: Variables such as injury severity, age, level of intoxication on admission and presence of surgeries should be considered when determining acute outcome.

• Traumatic brain injury
• motor vehicle collision
• assaults
• violence
• acute care