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Long-Term Survival after traumatic brain injury: A population-based analysis

This population-based retrospective cohort study identified all Olmsted County, MN residents with any diagnosis indicative of potential traumatic brain injury (TBI) during the years 1985-2000. The complete community-based medical records of a random sample (n=7,175) were reviewed to confirm and characterize the event, and to determine vital status through 2002. The review identified 1, 448 confirmed incident cases; 164 (11%) were moderate to severe; 1,284 were mild. The estimated 30-day fatality rate was 29% for moderate to severe cases and 0.2% for mild cases. Comparison of observed mortality over the full period of follow-up with that expected revealed a risk ratio (95 % CI) of 5.29 (4.11-6.71) for moderate to severe cases and 1.33 (1.05-1.65) for mild cases. Proportional hazards modeling showed the adjusted hazard of all-cause-mortality for moderate to severe cases relative to mild cases was 5.18 (3.65-7.3) within six months of the event and 1.04 (0.57-1.88) for the remaining follow-up period. This analysis indicates that persons who experience a mild TBI exhibit a small but statistically significant reduction in long-term survival compared to the general population. The case fatality rate for persons with moderate to severe TBI is very high, but among six-month survivors, long-term survival is similar to that for persons with mild TBI.

Registry Project Number: 429
Lead Investigator: Brown, A
Lead Center for Project: Mayo Medical Center
Collaborating Investigators: Leibson, C, Malec, J, Diehl, N
Date of Completion: 09/28/2004
Type: Local
Status of Project: Latest Information Shown

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