Citation

Owens PW, Lynch NP, O'Leary DP, Lowery AJ, Kerin MJ. Brain Inj. 2018; 32(7): 900-906.

Affiliation

Discipline of Surgery , Lambe Institute for Translational Research, NUI Galway , Galway , Ireland.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2018.1466366

PMID

29683734

Abstract

BACKGROUND: Traumatic brain injury (TBI) represents a significant burden of care for acute surgical services, particularly in the absence of on-site neurosurgical cover or sufficient post-acute rehabilitation facilities. We examine factors contributing to TBI, prolonged lengths of stay (LoS) and implications for hospital resources. Long-term outcomes are assessed.

METHODS: This is a retrospective cohort study of patients admitted to a regional trauma unit with TBI from 2008 to 2013. Patients with LoS > 48 h were assessed. Demographic, clinical and longitudinal mortality data were collected using electronic clinical and radiological systems and chart review.

RESULTS: A total of 690 patients presented with TBI from 2008 to 2013; 213 patients with LoS > 48 h were assessed. One hundred and thirty (61%) were male. Mean age was 56 years (±SD 24). Mechanical fall was the most frequent injury mechanism (n = 120/213, 56%). Twenty-five per cent were associated with alcohol consumption; these were more likely to be male, involved in an Road Traffic Accident (RTA) or assault and necessitate transfer to a neurosurgical unit (p < 0.001, p = 0.029, p < 0.001, p = 0.05). A total of 112 patients(53%) had a prolonged LoS (>2 weeks). Mean LoS was 20 days (±SD 35), increasing to 39 days for patients requiring neurosurgical intervention. The 12-month all-cause mortality rate was 12%.

CONCLUSIONS: TBIs result in significant utilisation of acute inpatient bed days. Improved rehabilitation services and strategies to reduce acute hospital LoS are warranted.

Language: en

Keywords

Head injury; alcohol; length of stay; rehabilitation; trauma; traumatic brain injury