Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain

Frontiers in Public Health

Public Health

Joan Farre¹  Maria Bernal¹  Oriol Yuguero²  Ana Vena²  Francisco Purroy³  Montserrat Martínez-Alonso⁴ 

[1] Clinical Laboratory, University Hospital Arnau de Vilanova, Lleida, Spain;ERLab Emergency Research Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida, Lleida, Spain;Faculty of Medicine, University of Lleida, Lleida, Spain;Faculty of Medicine, University of Lleida, Lleida, Spain;Neurosciences Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida, Lleida, Spain;Systems Biology and Statistical Methods for Biomedical Research Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida, Lleida, Spain;

关键词: TBI;    survival;    geriatric;    emergency;    falls;   

DOI  :  10.3389/fpubh.2023.1109426

 received in 2022-11-27, accepted in 2023-02-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionTraumatic brain injury (TBI) is a very important reason for consultation in emergency departments.MethodsA hospital cohort study with patients who attended a hospital emergency department between June 1, 2018 and December 31, 2020 due to TBI was studied. Clinical and sociodemographic variables were recorded. The levels of biomarkers and management variables were used. Qualitative variables were analyzed using Pearson's chi-square test, and quantitative variables using the Mann–Whitney U-test. Survival analyses were performed by fitting a multivariable Cox regression model for patient survival during the follow-up of the study in relation to the patient's characteristics upon admission to the emergency department.ResultsA total of 540 patients were included. The mean age was 83 years, and 53.9% of the patients were men. Overall, 112 patients (20.7%) died during the study follow-up. The mortality rate per 100 person-years was 14.33 (11.8–17.24), the most frequent mechanism being falls in the home, with none caused on public roads. The multivariable Cox proportional hazards model showed that survival after TBI was significantly associated with age, S100 levels, Charlson index, patient's institutionalized status, the place where the TBI occurred, and hemoglobin and platelet levels.DiscussionThe most common profile for a patient with a TBI was male and aged between 80 and 90 years. The combination of the variables age, Charlson index, place of TBI occurrence, and hemoglobin and platelet levels could offer early prediction of survival in our population independently of TBI severity. With the data obtained, a therapeutic algorithm could be established for patients suffering from mild TBI, allowing the patient to be supervised at home, avoiding futile referrals to emergency services.

【 授权许可】

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Copyright © 2023 Yuguero, Vena, Bernal, Martínez-Alonso, Farre and Purroy.