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Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury
BACKGROUND: Anemia might contribute to the development of secondary injury in patients with acute traumatic brain injury (TBI). Potential determinants of anemia are still poorly acknowledged, and reported incidence of declined hemoglobin concentration varies widely between different studies. The aim...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671999/ https://www.ncbi.nlm.nih.gov/pubmed/35915348 http://dx.doi.org/10.1007/s12028-022-01561-9 |
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author | Vanhala, Heidi Junttila, Eija Kataja, Anneli Huhtala, Heini Luostarinen, Teemu Luoto, Teemu |
author_facet | Vanhala, Heidi Junttila, Eija Kataja, Anneli Huhtala, Heini Luostarinen, Teemu Luoto, Teemu |
author_sort | Vanhala, Heidi |
collection | PubMed |
description | BACKGROUND: Anemia might contribute to the development of secondary injury in patients with acute traumatic brain injury (TBI). Potential determinants of anemia are still poorly acknowledged, and reported incidence of declined hemoglobin concentration varies widely between different studies. The aim of this study was to investigate the incidence of severe anemia among patients with moderate to severe TBI and to evaluate patient- and trauma-related factors that might be associated with the development of anemia. METHODS: This retrospective cohort study involved all adult patients admitted to Tampere University Hospital’s emergency department for moderate to severe TBI (August 2010 to July 2012). Detailed information on patient demographics and trauma characteristics were obtained, including data on posttraumatic care, data on neurosurgical procedures, and all measured in-hospital hemoglobin values. Severe anemia was defined as a hemoglobin level less than 100 g/L. Both univariate and multivariable analyses were performed, and hemoglobin trajectories were created. RESULTS: The study included 145 patients with moderate to severe TBI (male 83.4%, mean age 55.0 years). Severe anemia, with a hemoglobin level less than 100 g/L, was detected in 66 patients (45.5%) and developed during the first 48 h after the trauma. In the univariate analysis, anemia was more common among women (odds ratio [OR] 2.84; 95% confidence interval [CI] 1.13–7.15), patients with antithrombotic medication prior to trauma (OR 3.33; 95% CI 1.34–8.27), patients with cardiovascular comorbidities (OR 3.12; 95% CI 1.56–6.25), patients with diabetes (OR 4.56; 95% CI 1.69–12.32), patients with extracranial injuries (OR 3.14; 95% CI 1.69–12.32), and patients with midline shift on primary head computed tomography (OR 2.03; 95% CI 1.03–4.01). In the multivariable analysis, midline shift and extracranial traumas were associated with the development of severe anemia (OR 2.26 [95% CI 1.05–4.48] and OR 4.71 [95% CI 1.74–12.73], respectively). CONCLUSIONS: Severe anemia is common after acute moderate to severe TBI, developing during the first 48 h after the trauma. Possible anemia-associated factors include extracranial traumas and midline shift on initial head computed tomography. |
format | Online Article Text |
id | pubmed-9671999 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-96719992022-11-19 Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury Vanhala, Heidi Junttila, Eija Kataja, Anneli Huhtala, Heini Luostarinen, Teemu Luoto, Teemu Neurocrit Care Original Work BACKGROUND: Anemia might contribute to the development of secondary injury in patients with acute traumatic brain injury (TBI). Potential determinants of anemia are still poorly acknowledged, and reported incidence of declined hemoglobin concentration varies widely between different studies. The aim of this study was to investigate the incidence of severe anemia among patients with moderate to severe TBI and to evaluate patient- and trauma-related factors that might be associated with the development of anemia. METHODS: This retrospective cohort study involved all adult patients admitted to Tampere University Hospital’s emergency department for moderate to severe TBI (August 2010 to July 2012). Detailed information on patient demographics and trauma characteristics were obtained, including data on posttraumatic care, data on neurosurgical procedures, and all measured in-hospital hemoglobin values. Severe anemia was defined as a hemoglobin level less than 100 g/L. Both univariate and multivariable analyses were performed, and hemoglobin trajectories were created. RESULTS: The study included 145 patients with moderate to severe TBI (male 83.4%, mean age 55.0 years). Severe anemia, with a hemoglobin level less than 100 g/L, was detected in 66 patients (45.5%) and developed during the first 48 h after the trauma. In the univariate analysis, anemia was more common among women (odds ratio [OR] 2.84; 95% confidence interval [CI] 1.13–7.15), patients with antithrombotic medication prior to trauma (OR 3.33; 95% CI 1.34–8.27), patients with cardiovascular comorbidities (OR 3.12; 95% CI 1.56–6.25), patients with diabetes (OR 4.56; 95% CI 1.69–12.32), patients with extracranial injuries (OR 3.14; 95% CI 1.69–12.32), and patients with midline shift on primary head computed tomography (OR 2.03; 95% CI 1.03–4.01). In the multivariable analysis, midline shift and extracranial traumas were associated with the development of severe anemia (OR 2.26 [95% CI 1.05–4.48] and OR 4.71 [95% CI 1.74–12.73], respectively). CONCLUSIONS: Severe anemia is common after acute moderate to severe TBI, developing during the first 48 h after the trauma. Possible anemia-associated factors include extracranial traumas and midline shift on initial head computed tomography. Springer US 2022-08-02 2022 /pmc/articles/PMC9671999/ /pubmed/35915348 http://dx.doi.org/10.1007/s12028-022-01561-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Work Vanhala, Heidi Junttila, Eija Kataja, Anneli Huhtala, Heini Luostarinen, Teemu Luoto, Teemu Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title | Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title_full | Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title_fullStr | Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title_full_unstemmed | Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title_short | Incidence and Associated Factors of Anemia in Patients with Acute Moderate and Severe Traumatic Brain Injury |
title_sort | incidence and associated factors of anemia in patients with acute moderate and severe traumatic brain injury |
topic | Original Work |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671999/ https://www.ncbi.nlm.nih.gov/pubmed/35915348 http://dx.doi.org/10.1007/s12028-022-01561-9 |
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