期刊
JOURNAL OF NEUROTRAUMA
卷 32, 期 23, 页码 1883-1892出版社
MARY ANN LIEBERT, INC
DOI: 10.1089/neu.2014.3454
关键词
brain injuries; brain injury; chronic; disorder of consciousness; epidemiology; life expectancy; mortality; rehabilitation
资金
- National Institute on Disability and Rehabilitation Research, Office of Special Education Services, Department of Education [H133A110006]
- Indiana University School of Medicine [H133A120085]
- Mount Sinai School of Medicine [H133A100284]
- Department of Veterans Affairs
- Department of Education, National Institute on Disability and Rehabilitation Research
- VA HSRD
- Department of Education
- [1 I50 HX001233-01]
- [SDR 13-228]
Severe traumatic brain injury (TBI) has been associated with increased mortality. This study characterizes long-term mortality, life expectancy, causes of death, and risk factors for death among patients admitted within the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems Programs (TBIMS) who lack command following at the time of admission for inpatient TBI rehabilitation. Of the 8084 persons enrolled from 1988 and 2009, 387 from 20 centers met study criteria. Individuals with moderate to severe TBI who received inpatient rehabilitation were 2.2 times more likely to die than individuals in the U.S. general population of similar age, gender, and race, with an average life expectancy (LE) reduction of 6.6 years. The subset of individuals who were unable to follow commands on admission to rehabilitation was 6.9 times more likely to die, with an average LE reduction of 12.2 years. Relative to the U.S. general population matched for age, gender, and race/ethnicity, these non-command following individuals were more than four times more likely to die of circulatory conditions, 44 times more likely to die of pneumonia, and 38 times more likely to die of aspiration pneumonia. The subset of individuals with TBI who are unable to follow commands upon admission to inpatient rehabilitation are at a significantly increased risk of death when compared with the U.S. general population and compared with all individuals with moderate to severe TBI receiving inpatient rehabilitation. Respiratory causes of death predominate, compared with the general population.
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