Higher haemoglobin levels and dedicated trauma admission are associated with survival after severe traumatic brain injury.

Abstract:

BACKGROUND:Prevention of secondary brain injury is a key component of acute management of patients with severe traumatic brain injury (TBI). Haemoglobin concentration may have an impact on optimization of cerebral oxygenation. Patients with TBI may best be served by an organized trauma service. The objective is to determine if haemoglobin concentration or dedicated trauma admission has an impact on outcomes after severe TBI. METHODS:This study retrospectively analysed consecutive patients with severe TBI admitted to a level-I trauma centre over 3 years. Patients <16 years-old and with length of stay (LOS) <24 hours were excluded. Data were collected on demographics; injury severity; LOS; admission service; survival to discharge; and haemoglobin levels from hospital days 1-7. Data were also collected on number of transfusions of packed red blood cells. The sample was stratified based on admission service and survival to discharge. RESULTS:Of 147 patients (age = 54.1 ± 3.7 years), overall mortality rate was 15.4% (n = 23). Overall, non-survivors had lower daily and 7-day mean haemoglobin levels (10.7 ± 0.9 vs. 12.9 ± 0.4 g dL(-1), p < 0.001). Non-surgical admissions had lower haemoglobin levels and a higher mortality rate (28.9% vs. 12.2%, p < 0.001) compared to dedicated trauma admissions. CONCLUSIONS:Among patients with severe TBI, higher haemoglobin levels and maintenance as a dedicated trauma admission are associated with higher survival to discharge.

journal_name

Brain Inj

journal_title

Brain injury

authors

Baltazar GA,Pate AJ,Panigrahi B,Sharp A,Smith M,Chendrasekhar A

doi

10.3109/02699052.2015.1004558

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

607-11

issue

5

eissn

0269-9052

issn

1362-301X

journal_volume

29

pub_type

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