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Title: Mortality following traumatic brain injury inpatient rehabilitation.
Authors: Spitz, Gershon
Downing, Marina
Ponsford, Jennie
McKenzie, Dean
Keywords: Traumatic Brain Injury
Risk Factors
Standardised Mortality Ratio
Cox Proportional Hazards Regression Model
Clinical Trials and Research Centre , Epworth Healthcare, Melbourne, Australia
Monash-Epworth Rehabilitation Research Centre, Epworth Hospital , Melbourne, Australia
Issue Date: Aug-2015
Publisher: Mary Ann Liebert
Citation: J Neurotrauma. 2015 Aug 15;32(16):1272-80
Abstract: The aim of this study was to examine the rate and causes of mortality following mild to severe traumatic brain injury (TBI) rehabilitation and to develop a multivariate prognostic model of mortality. We conducted a cohort study of 3341 individuals with mild to severe TBI followed-up from a post-acute inpatient rehabilitation center. Rate of death and survival between one and 26 years following injury were examined using standardized mortality ratios (SMRs) and prognostic models developed using Cox regression. A mortality rate of 9.3% was observed and an overall SMR of 1.04 (95% confidence interval [CI]=1.04-1.05). A statistically significant elevated SMR of 1.20 (95% CI=1.06-1.37) was observed for males, and both males and females had an elevated risk of death from external causes. Females also were found to have a significantly elevated SMR of 5.02 (95% CI=1.36-12.80) for intentional self-harm. Individuals ages 15-44 had a two-fold increase in mortality, compared with the general population. The multivariate Cox model indicated that increased risk of mortality was associated with older age, being male, being unemployed prior to injury, having a history of stroke, alcohol use, mental health issues, and back injury sustained in the accident. Premorbid lifestyle factors exerted a greater influence on mortality following TBI, compared with injury-related factors. This risk was especially prominent for younger individuals, who died primarily due to external causes. These findings highlight the need for interventions that address premorbid issues, such as substance abuse and mental health issues.
DOI: 10.1089/neu.2014.3814
PubMed URL:
ISSN: 0897-7151
Journal Title: Journal of Neurotrauma
Type: Journal Article
Affiliated Organisations: School of Psychological Sciences, Monash University , Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University , Melbourne, Australia
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Mental Health

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