Mortality from traumatic brain injury
Part of the
Acta Neurochirurgica Supplementum
book series (NEUROCHIRURGICA, volume 95)
It is the general sense that mortality has been decreasing in recent years compared to earlier studies described by the NIH traumatic coma data bank. We studied mortality during the period of 1984 to 1996 to determine if indeed mortality from severe traumatic brain injury was decreasing and to identify factors which might account for the reduction. The study population (N = 1839) consisted of severely head injured patients extracted retrospectively from the TCDB (635), MCV (382), and 822 patients from clinical trial databases conducted in the United States. Mortality was obtained from each of the databases for the age range form 16 to 65. Penetrating injury and treatment groups in the clinical trial databases were excluded. Mortality in the year 1984 equaled 39% and gradually decreased to a level of 27% in 1996. When adjusting for age, motor score and pupil reaction, the mortality of the period from 1984 to 1987 was significantly higher (p < 0:05) than that of the period 1988 to 1996.
During the period 1984 through 1996, mortality from severe brain injury steadily declined. Factors other than age, motor score and pupil reactivity over time are responsible for this reduction. This reduction over time is an important factor for prognostic modeling of TBI.
KeywordsTraumatic brain injury clinical trial outcome from traumatic brain injury
Becker DP, Miller JD, Ward JD, Greenberg RP, Young HF, Sakalas Rl (1977) The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47(4): 491–502PubMedGoogle Scholar
Choi SC, Muizelaar JP, Barnes TY, Marmarou A, Brooks DM, Young HF (1991) Prediction tree for severely head-injured patients. J Neurosurg 75(2): 251–255PubMedGoogle Scholar
Choi SC, Narayan RK, Anderson RL, Ward JD (1988) Enhanced specificity of prognosis in severe head injury. J Neurosurg 69(3): 381–385PubMedGoogle Scholar
Choi SC, Ward JD, Becker DP (1983) Chart for outcome prediction in severe head injury. J Neurosurg 59(2): 294–297PubMedGoogle Scholar
Hukkelhoven CW, Steyerberg EW, Rampen AJ, Farace E, Habbema JD, Marshall LF, Murray GD, Maas AI (2003) Patient age and outcome following severe traumatic brain injury: an analysis of 5600 patients. J Neurosurg 99(4): 666–673PubMedGoogle Scholar
Klauber MR, Marshall LF, Toole BM, Knowlton SL, Bowers SA (1985) Cause of decline in head-injury mortality rate in San Diego County, California. J Neurosurg 62(4): 528–531PubMedCrossRefGoogle Scholar
Rosner MJ (1996) Role of cerebral perfusion pressure in acute brain trauma. Crit Care Med 24(7): 1274, author reply 1275–1276PubMedCrossRefGoogle Scholar
Rosner MJ, Daughton S (1990) Cerebral perfusion pressure management in head injury. J Trauma 30(8): 933–940; discussion 940–941PubMedCrossRefGoogle Scholar
Rosner MJ, Rosner SD, Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83(6): 949–962PubMedCrossRefGoogle Scholar