Late mortality after severe traumatic brain injury in New South Wales: a multicentre study

Ian J. Baguley, Melissa T. Nott, Alison A. Howle, Grahame K. Simpson, Stuart Browne, A Clayton King, Rachel E. Cotter, Adeline Hodgkinson

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Objectives: To determine the long-term mortality pattern of adults with severetraumatic brain injury (TBI), and to identify the risk factors associated withdeath in this group.Design, patients and setting: Inception cohort study of 2545 adultsconsecutively discharged from one of three metropolitan tertiary, post-acuteinpatient rehabilitation services of the New South Wales Brain InjuryRehabilitation Program from 1 January 1990 to 1 October 2007 after inpatientrehabilitation for primary TBI.Main outcome measure: Survival status at 1 October 2009.Results: 258 deaths were recorded in this sample, yielding a standardisedmortality ratio of 3.19 (95% CI, 2.80'3.60). Risk of death remained elevatedabove societal norms for at least 8 years after discharge from rehabilitation.Mortality risk was increased by: functional dependence at discharge; age atinjury; pre-injury drug and alcohol misuse; pre-injury epilepsy; and discharge toan aged care facility. The risk of death from external causes, and respiratorysystem and nervous system disorders was six to seven times higher, and the riskof death from disorders of the digestive system, and mental and behaviouraldisorders was five times higher in adults with severe TBI than in the generalpopulation.Conclusions: People who survive to discharge from inpatient rehabilitationfollowing a severe TBI were found to have a sustained increase in risk of deathfor eight years post discharge. Various demographic and injury-related variablesselectively increase mortality risk and may be modifiable in order to reduce theobserved increase in mortality.
Original languageEnglish
Pages (from-to)40-45
Number of pages6
JournalMedical Journal of Australia
Volume196
Issue number1
DOIs
Publication statusPublished - Jan 2012

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