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

INTRODUCTION: Traumatic brain injury (TBI) is a very important reason for consultation in emergency departments. METHODS: A 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 sociodemographi...

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Autores principales: Yuguero, Oriol, Vena, Ana, Bernal, Maria, Martínez-Alonso, Montserrat, Farre, Joan, Purroy, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067594/
https://www.ncbi.nlm.nih.gov/pubmed/37020814
http://dx.doi.org/10.3389/fpubh.2023.1109426
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author Yuguero, Oriol
Vena, Ana
Bernal, Maria
Martínez-Alonso, Montserrat
Farre, Joan
Purroy, Francisco
author_facet Yuguero, Oriol
Vena, Ana
Bernal, Maria
Martínez-Alonso, Montserrat
Farre, Joan
Purroy, Francisco
author_sort Yuguero, Oriol
collection PubMed
description INTRODUCTION: Traumatic brain injury (TBI) is a very important reason for consultation in emergency departments. METHODS: A 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. RESULTS: A 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. DISCUSSION: The 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.
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spelling pubmed-100675942023-04-04 Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain Yuguero, Oriol Vena, Ana Bernal, Maria Martínez-Alonso, Montserrat Farre, Joan Purroy, Francisco Front Public Health Public Health INTRODUCTION: Traumatic brain injury (TBI) is a very important reason for consultation in emergency departments. METHODS: A 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. RESULTS: A 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. DISCUSSION: The 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. Frontiers Media S.A. 2023-03-20 /pmc/articles/PMC10067594/ /pubmed/37020814 http://dx.doi.org/10.3389/fpubh.2023.1109426 Text en Copyright © 2023 Yuguero, Vena, Bernal, Martínez-Alonso, Farre and Purroy. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Yuguero, Oriol
Vena, Ana
Bernal, Maria
Martínez-Alonso, Montserrat
Farre, Joan
Purroy, Francisco
Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title_full Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title_fullStr Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title_full_unstemmed Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title_short Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain
title_sort platelet levels and age are determinants of survival after mild–moderate tbi: a prospective study in spain
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067594/
https://www.ncbi.nlm.nih.gov/pubmed/37020814
http://dx.doi.org/10.3389/fpubh.2023.1109426
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