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Table 2 Description of the characteristics of individuals with TBI and their association with ICU outcome

From: Epidemiological and clinical characteristics predictive of ICU mortality of patients with traumatic brain injury treated at a trauma referral hospital – a cohort study

VARIABLES

Total

(n = 1114)

Discharge

Death

p value

ICU ADMISSION

    

Age (years), mean ± SD

45.3 ± 19.1

44.5 ± 18.9

47.6 ± 19.7

0.016b

Male, n (%)*

948 (85.1)

689 (72.7)

259 (27.3)

0.707c

Trauma mechanism, n (%) *

   

< 0.001a

GSW/SW

77 (7.4)

47 (56.6)

36 (43.4)

Physical Aggression

142 (12.7)

113 (79.6)

29 (20.4)

Run over

158 (14.2)

104 (65.8)

54 (34.2)

Cyclist

50 (4.5)

29 (58)

21 (42)

Collision

93 (8.3)

73 (78.5)

20 (21.5)

Motorbike

203 (18.2)

159 (78.3)

44 (21.7)

SLF

238 (21.4)

172 (72.3)

66 (27.7)

OLF

147 (13.2)

110 (74.8)

37 (25.2)

Passage to the operating room before ICU addition, n(%)

   

0,033c

Yes

789 (70.8)

557 (70.6)

232 (29.4)

No

325 (29.2)

250 (76.9)

75 (23.1)

Apache II score, mean; med. (min-max)

20; 19 (0–49)

16.5; 15 (0–41)

29.1; 30 (6–49)

0.000d

Worst Glasgow Coma Scale (GCS) in the first 24 h, mean; med. (min-max)

9; 10 (3–15)

10.5; 12 (3–15)

5.3; 3 (3–15)

0.000d

Classification of Severity of TBI by the worst GCS in the first 24 h, n(%)

   

< 0,001a

Severe (GCS 3 to 8)

519 (46.6)

264 (50.9)

255 (49.1)

Moderate (GCS 9 to 12)

205 (18.4)

176 (85.9)

29 (14.1)

Mild (GCS 13 to 15)

390 (35.0)

367 (94.1)

23 (5.9)

SOFA score in the first 24 h, mean; med. (min-max) #

6.5; 6 (0–18)

5.4; 5 (0–16)

9.5; 9 (2–18)

0.000d

Number of injuries on cranial CT, n (%) *

   

< 0.001a

None

43 (3.9)

39 (90.7)

4 (9.3)

One

736 (66.1)

552 (75)

184 (25)

Two

250 (22.4)

176 (70.4)

74 (29.6)

Three

85 (7.6)

40 (47.1)

45 (52.9)

Injuries evidenced on CT, n (%) *

    

Cerebral contusion

167 (15.0)

122 (73.1)

45 (26.9)

0.015e

DAI

47 (4.2)

40 (85.1)

7 (14.9)

0.527e

Fracture and/or depression

99 (8.9)

70 (70.7)

29 (29.3)

0.009e

SAH

379 (34.0)

244 (64.4)

135 (35.6)

< 0.001e

SDH

401 (36.0)

268 (66.8)

133 (33.2)

< 0.001e

EDH

151 (13.6)

127 (84.1)

24 (15.9)

0.335e

IPH

149 (13.4)

112 (75.2)

37 (24.8)

0.034e

Haemoventriculum

19 (1.7)

8 (42.1)

11 (57.9)

< 0.001e

Cerebral edema

55 (4.9)

17 (30.9)

38 (69.1)

< 0.001e

Ischaemia

8 (0.7)

2 (25)

6 (75)

< 0.001e

Pneumocephalus

13 (1.2)

11 (84.6)

2 (15.4)

0.615e

Presence of polytrauma, n (%) *

318 (28.5)

230 (72.3)

88 (27.7)

1c

Number of injury follow-ups in addition to TBI, n (%) *

   

0.260a

None

796 (71.5)

577 (72.5)

219 (27.5)

One

190 (17.1)

142 (74.7)

48 (25.3)

Two

94 (8.4)

61 (64.9)

33 (35.1)

Three or more

34 (3.1)

27 (79.4)

7 (20.6)

Injury follow-up in addition to TBI, n (%) *

    

Thorax

140 (44)

87 (62.1)

53 (37.9)

0,015f

Abdomen

56 (17.6)

37 (66.1)

19 (33.9)

0,355f

Pelvis

14 (4.4)

11 (78.6)

3 (21.4)

0,768f

SCI

59 (18.6)

44 (74.6)

15 (25.4)

0,880f

Limbs

129 (40.6)

93 (72.1)

36 (27.9)

0,916f

Face and/or neck (except spine)

84 (26.4)

75 (89.3)

9 (10.7)

< 0,001f

TREATMENT OF TBI

    

Approach to TBI treatment, n (%) *

   

0,138c

Conservative

494 (44.3)

369 (74.7)

125 (25.3)

Surgical

620 (55.7)

438 (70.6)

182 (29.4)

Procedures performed to treat TBI, n (%) *

    

ICPm

418 (67.4)

272 (65.1)

146 (34.9)

0,002 g

Craniectomy

158 (25.5)

86 (54.4)

72 (45.6)

< 0.001 g

Haematoma drainage

140 (22.6)

122 (87.1)

18 (12.9)

0.002 g

EVD

94 (15.5)

71 (75.5)

23 (24.5)

1 g

Correction of fracture and/or depression

8 (1.3)

8 (100)

0 (0)

0.210 g

ICU OUTCOME

    

Length of stay, mean; med. (min-max)

10.8; 7 (1–90)

12; 8 (1–90)

7.4; 5 (1–74)

< 0.001d

Level of LST, n (%) §

   

< 0.001a

LST-A

803 (74.1)

742 (92.4)

61 (7.6)

LST-B

74 (6.8)

24 (32.4)

50 (67.6)

LST-C

77 (7.1)

14 (18.2)

63 (81.8)

LST-D

17 (1.6)

1 (5.6)

17 (94.4)

LST-E

113 (10.4)

0 (0)

113 (100)

  1. Abbreviations: TBI, traumatic brain injury; ICU, intensive care unit; OR, odds ratio; GSW, Gunshot wound; SW, Stab wound; SLF, Same-level fall; OLF, Fall from height; SCI, spinal cord injure; APACHE, Acute Physiology and Chronic Health Evaluation; CT, computed tomography; DAI, Diffuse axonal injury; SAH, Subarachnoid haemorrhage; SDH, subdural haematoma; EDH, epidural haematoma; IPH, Intraparenchymal haemorrhage; ICPm, intra cranial pressure monitoring; EVD, External ventricular derivation; LST: life-sustaining treatments; LST-A: All necessary, possible, and available LST measures to save life and restore health, including cardiopulmonary resuscitation if cardiopulmonary arrest; LST-B: All necessary, possible, and available LST measures to save life and restore health, but no cardiopulmonary resuscitation if cardiopulmonary arrest; LST-C: Maintenance of LST measures already in place, withholding new ones apart from those aimed at comforting the patient and his or her family; LST-D: Removal of LST measures when considered futile in the face of a terminal condition and beginning of palliative care; LSTT-E: All necessary, possible and available LST measures for patients with brain death until organ donation
  2. * For the variables in the column “Total”, the percentages calculated are presented considering the total number of cases in the column, while in the columns “Discharge” and “Death”, the percentages calculated considering the total number of cases in the row are presented
  3. # 140 missing data points in the total sample (88 among discharges and 52 among deaths)
  4. §  30 missing data points in the total sample (26 among discharges and 4 among deaths)
  5. a Significant, chi-square test
  6. b Significant, Student’s t test for independent samples
  7. c Significant, Fisher’s exact test
  8. d Significant, nonparametric Mann‒Whitney test
  9. e Significant, Fisher’s exact test, compared with the 43 patients who did not present any injury on cranial CT.
  10. f Significant, Fisher’s exact test, compared with the 796 patients who had no record of injuries
  11. g Significant, Fisher’s exact test, compared with the 494 patients who underwent conservative treatment