This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Original research
Traumatic brain injury - the effects of patient age on treatment intensity and mortality
Ola Skaansar
Universitetet i Oslo
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6343-1137
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Ageing is associated with worse treatment outcome after traumatic brain injury (TBI). This association may lead to a self-fulfilling prophecy that affects treatment efficacy. The aim of the current study was to evaluate the role of treatment bias in patient outcomes by studying the intensity of diagnostic procedures, treatment, and overall 30-day mortality in different age groups of patients with TBI.
Methods
Included in this study was consecutively admitted patients with TBI, aged ≥ 15 years, with a cerebral CT showing intracranial signs of trauma, during the time-period between 2015–2018. Data were extracted from our prospective quality control registry for admitted TBI patients. As a measure of management intensity in different age groups, we made a composite score, where use of advanced TBI imaging, placement of intracranial pressure monitor, ventilator treatment, and evacuation of intracranial mass lesion each gave one point. Uni- and multivariate survival analyses were performed using logistic multinomial regression.
Results
A total of 1,571 patients with TBI fulfilled the inclusion criteria. The median age was 58 years (range 15–98), 70% were men, and 39% were ≥ 65 years. Head injury severity was mild in 706 patients (45%), moderate in 437 (28%), and severe in 428 (27%). Increasing age was associated with less management intensity, as measured using the composite score, irrespective of head injury severity. Multivariate analyses showed that the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, moderate/severe TBI, Rotterdam CT-score ≥ 4, and low management intensity (composite score ≤ 3).
Conclusion
The present study indicates that the management intensity of hospitalised patients with TBI decreased with advanced age and that low management intensity was associated with an increased risk of 30-day mortality. This suggests that the high mortality among elderly TBI patients may have an element of treatment bias and could in the future be limited with a more aggressive management regime.
Keywords
traumatic brain injury, neurosurgery, age, treatment, mortality, management intensity
Figure 1
Figure 2
Figure 3
Patients
Included in this study were 1,571 consecutive adult patients with TBI (aged ≥ 15 years) and with a cerebral CT showing signs of trauma. Patient characteristics are presented in Table 1. Seventy per cent of the patients were men. The male preponderance was clear in patients aged 15–74 years, while among patients aged 75 years or older there was a gradual shift to a female preponderance. The median age was 58 years (range 15–98). The fractions of patients aged 65 years or older, 75 years or older, and 85 years or older were 39%, 20%, and 8%, respectively.
Increasing age was significantly associated with a higher comorbidity (ASA score 3–4) (p < 0.001), need for assistance in daily life (p < 0.001), and the use of antithrombotic medication (p < 0.001). Falls were the most frequent injury mechanism (55%), followed by motor vehicle accidents (10%), sports accidents (including bicycles) (9%), and violence/self-harm (10%). The proportion of fall-related injuries increased significantly with increasing age (p < 0.001) (Fig. 1).
Head injury severity
Mean GCS score, HISS severity grade, and Rotterdam CT-score for the different age groups are presented in Table 1. The mean GCS score and the fraction of mild TBI increased with increasing age (p < 0.03), indicating less severe TBI with increasing age. In contrast, the Rotterdam CT score showed a gradual increase with increasing age, indicating more severe injury in the higher age groups (p < 0.001). The fraction of patients with multiple trauma decreased with increasing age (p < 0.001).
Patient management
The trauma team was activated for initial triage in 77% of the patients, advanced TBI imaging was performed in 60%, ICP-monitoring was used in 24%, ventilator treatment was applied to 41%, surgical evacuation of intracranial mass lesion was done in 14%, and decompressive craniectomy was performed in 2% (Table 1).
TTA, advanced TBI imaging, invasive ICP monitoring, and ventilator treatment all declined significantly with increasing age (p < 0.001). There was no significant change in the rate of surgery with increasing age for mild and moderate TBI, but for severe TBI the age curve was parabola shaped, indicating a low rate of surgery in both young and elderly patients compared to the middle-aged patient group. Decompressive craniectomy was not performed in any patients ≥ 75 years. Figure 2 shows the effect of age on the management intensity (composite score). The graphs demonstrate that increasing age is associated with lower management intensity irrespective of head injury severity.
Mortality
OS analyses were conducted using Kaplan–Meier curves (Fig. 3). 30-day overall mortality was 12%. 30-day mortality in the age groups 15–54 years, 55–64 years, 65–74 years, 75–84 years and ≥ 85 years was 6%, 11%, 11%, 23% and 24%, respectively. Uni- and multivariate survival analyses were performed using logistic multinomial regression (Table 2). In the multivariate analyses, the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, moderate/severe TBI, Rotterdam CT-score ≥ 4, and low management intensity (composite score ≤ 3). Severe comorbidities (pre-injury ASA ≥ 3) approached a significance level (p = 0.069). Sex was not associated with 30-day survival.
| Table 1 Baseline patient characteristics for 1,571 patients by age groups | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 15-24yrs | 25-34yrs | 35-44yrs | 45-54yrs | 55-64yrs | 65-74yrs | 75-84yrs | ≥ 85yrs | |||||
| Count (n, %) | 179 (100) | 168 (100) | 153 (100) | 197 (100) | 258 (100) | 297 (100) | 197 (100) | 122 (100) | ||||
| Male sex (n, %) | 134 (74.9) | 134 (79.8) | 125 (81.7) | 145 (73.6) | 195 (75.6) | 201 (67.7) | 112 (56.9) | 46 (37.7) | ||||
| Pre-injury ASA-score (n, %) | ||||||||||||
| 1 | 165 (92.2) | 134 (79.8) | 102 (66.7) | 114 (57.9) | 72 (27.9) | 66 (22.2) | 18 (9.1) | 4 (3.3) | ||||
| 2 | 11 (6.1) | 26 (15.5) | 31 (20.3) | 45 (22.8) | 88 (34.1) | 127 (42.8) | 86 (43.7) | 30 (24.6) | ||||
| 3 | 3 (1.7) | 7 (4.2) | 20 (13.1) | 38 (19.3) | 97 (37.6) | 97 (32.7) | 91 (46.2) | 85 (69.7) | ||||
| 4 | 0 (0) | 1 (0.6) | 0 (0) | 0 (0) | 1 (0.4) | 7 (2.4) | 2 (1.0) | 3 (2.5) | ||||
| Pre-injury living (n, %) | ||||||||||||
| Independent | 176 (98.3) | 162 (96.4) | 147 (96.1) | 185 (93.9) | 236 (91.5) | 269 (90.6) | 155 (78.7) | 51 (41.8) | ||||
| Home with assistance | 1 (0.6) | 5 (3.0) | 4 (2.6) | 8 (4.1) | 20 (7.8) | 22 (7.4) | 29 (14.7) | 54 (44.3) | ||||
| Institutionalised | 2 (1.1) | 1 (0.6) | 2 (1.3) | 4 (2.0) | 2 (0.8) | 6 (2.0) | 13 (6.6) | 17 (13.9) | ||||
| Pre-injury antithrombotics (n, %) | ||||||||||||
| Anticoagulation | 1 (0.6) | 0 (0) | 5 (3.3) | 2 (1.0) | 14 (5.4) | 33 (11.1) | 52 (26.4) | 38 (31.1) | ||||
| Platelet inhibitor | 0 (0) | 0 (0) | 1 (0.7) | 10 (5.1) | 38 (14.7) | 87 (29.3) | 68 (34.5) | 45 (36.9) | ||||
| Platelet inhibitor + anticoagulation | 0 (0) | 0 (0) | 1 (0.7) | 1 (0.5) | 3 (1.2) | 7 (2.4) | 7 (3.6) | 2 (1.6) | ||||
| GCS mean | 10.0 | 11.0 | 11.1 | 11.0 | 11.2 | 11.8 | 11.4 | 12.5 | ||||
| HISS (n, %) | ||||||||||||
| Mild | 62 (34.6) | 83 (49.4) | 68 (44.4) | 81 (41.1) | 111 (43.0) | 134 (45.1) | 94 (47.7) | 73 (59.8) | ||||
| Moderate | 50 (27.9) | 32 (19.0) | 41 (26.8) | 58 (29.4) | 74 (28.7) | 100 (33.7) | 50 (25.4) | 32 (26.2) | ||||
| Severe | 67 (37.4) | 53 (31.5) | 44 (28.8) | 58 (29.4) | 73 (28.3) | 63 (21.2) | 53 (26.9) | 17 (13.9) | ||||
| Pathoanatomy (n, %) | ||||||||||||
| Skull fracture | 121 (67.6) | 107 (63.7) | 95 (62.1) | 125 (63.5) | 135 (52.3) | 133 (44.8) | 56 (28.4) | 36 (29.5) | ||||
| SDH | 72 (40.2) | 73 (43.5) | 65 (42.5) | 109 (55.3) | 169 (65.5) | 192 (64.6) | 133 (67.5) | 77 (63.1) | ||||
| tSAH | 80 (44.7) | 104 (61.9) | 93 (60.8) | 116 (58.9) | 170 (65.9) | 189 (63.6) | 118 (59.9) | 72 (59.0) | ||||
| EDH | 47 (26.3) | 35 (20.8) | 34 (22.2) | 36 (18.3) | 33 (12.8) | 28 (9.4) | 9 (4.6) | 5 (4.1) | ||||
| Brain contusion | 100 (55.8) | 82 (48.8) | 82 (53.6) | 102 (51.8) | 138 (53.5) | 137 (46.1) | 87 (44.2) | 48 (39.3) | ||||
| Rotterdam CT score (n, %) | ||||||||||||
| 1–2 | 103 (57.5) | 82 (48.8) | 60 (39.2) | 76 (38.6) | 83 (32.2) | 89 (30.0) | 44 (22.3) | 38 (31.1) | ||||
| 3–4 | 66 (36.9) | 67 (39.9) | 80 (52.3) | 101 (51.3) | 152 (58.9) | 182 (61.3) | 132 (67.0) | 73 (59.8) | ||||
| 5–6 | 10 (5.6) | 19 (11.3) | 13 (8.5) | 20 (10.2) | 23 (8.9) | 26 (8.8) | 21 (10.7) | 11 (9.0) | ||||
| Multiple trauma (n, %) | ||||||||||||
| No | 78 (43.6) | 74 (44.0) | 75 (49.0) | 75 (38.1) | 124 (48.1) | 170 (57.2) | 121 (61.4) | 82 (61.4) | ||||
| Yes | 101 (56.4) | 94 (56.0) | 78 (51.0) | 122 (61.9) | 134 (51.9) | 127 (42.8) | 76 (38.6) | 40 (32.8) | ||||
| Management intensity (n, %) | ||||||||||||
| TTA | 165 (92.2) | 140 (83.3) | 129 (84.3) | 167 (84.8) | 214 (82.9) | 205 (69.0) | 127 (64.5) | 69 (56.6) | ||||
| CTA/CTV/MRA/MRV | 112 (62.6) | 97 (57.7) | 84 (54.9) | 123 (62.4) | 164 (63.6) | 163 (54.9) | 84 (42.6) | 21 (17.2) | ||||
| MR | 90 (50.3) | 52 (31.0) | 52 (34.0) | 69 (35.0) | 75 (29.1) | 50 (16.8) | 21 (10.7) | 4 (3.3) | ||||
| Ventilator therapy | 97 (54.2) | 69 (41.1) | 65 (42.5) | 89 (45.2) | 119 (46.1) | 112 (37.7) | 69 (35.0) | 22 (18.0) | ||||
| ICP-monitor | 62 (34.6) | 40 (23.8) | 42 (27.5) | 59 (29.9) | 81 (31.4) | 59 (19.9) | 27 (13.7) | 3 (2.5) | ||||
| Evacuation of mass lesion | 18 (10.1) | 22 (13.1) | 27 (17.6) | 27 (13.7) | 43 (16.7) | 49 (16.5) | 20 (10.2) | 10 (8.2) | ||||
| Decompressive craniectomy | 4 (2.2) | 4 (2.4) | 6 (3.9) | 9 (4.6) | 4 (1.6) | 4 (1.3) | 0 (0) | 0 (0) | ||||
| ASA: American Society of Anesthesiologists, LOC: Loss of consciousness, GCS: Glasgow Coma Scale, HISS: Head Injury Severity Scale, SDH: Subdural haematoma, tSAH: Traumatic subarachnoidal haemorrhage, EDH: Epidural haematoma, TTA: Trauma team activation, CTA: Computed tomography angiography, CTV: Computed tomography venography, MRA: Magnetic resonance angiography, MRV: Magnetic resonance venography, MR: Magnetic resonance, ICP: Intracranial pressure monitor | ||||||||||||
Due to technical limitations, Table 2 is provided in the Supplementary Files section. Caption: Table 2: Uni- and multivariate Cox regression analyses of parameters potentially associated with risk of death within 30-days of trauma.
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
Learn more about our company.
This is a preprint. It has not completed peer review.
Original research
Traumatic brain injury - the effects of patient age on treatment intensity and mortality
Ola Skaansar
Universitetet i Oslo
Corresponding Author
ORCiD: https://orcid.org/0000-0002-6343-1137
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Ageing is associated with worse treatment outcome after traumatic brain injury (TBI). This association may lead to a self-fulfilling prophecy that affects treatment efficacy. The aim of the current study was to evaluate the role of treatment bias in patient outcomes by studying the intensity of diagnostic procedures, treatment, and overall 30-day mortality in different age groups of patients with TBI.
Methods
Included in this study was consecutively admitted patients with TBI, aged ≥ 15 years, with a cerebral CT showing intracranial signs of trauma, during the time-period between 2015–2018. Data were extracted from our prospective quality control registry for admitted TBI patients. As a measure of management intensity in different age groups, we made a composite score, where use of advanced TBI imaging, placement of intracranial pressure monitor, ventilator treatment, and evacuation of intracranial mass lesion each gave one point. Uni- and multivariate survival analyses were performed using logistic multinomial regression.
Results
A total of 1,571 patients with TBI fulfilled the inclusion criteria. The median age was 58 years (range 15–98), 70% were men, and 39% were ≥ 65 years. Head injury severity was mild in 706 patients (45%), moderate in 437 (28%), and severe in 428 (27%). Increasing age was associated with less management intensity, as measured using the composite score, irrespective of head injury severity. Multivariate analyses showed that the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, moderate/severe TBI, Rotterdam CT-score ≥ 4, and low management intensity (composite score ≤ 3).
Conclusion
The present study indicates that the management intensity of hospitalised patients with TBI decreased with advanced age and that low management intensity was associated with an increased risk of 30-day mortality. This suggests that the high mortality among elderly TBI patients may have an element of treatment bias and could in the future be limited with a more aggressive management regime.
Figure 1
Figure 2
Figure 3
Patients
Included in this study were 1,571 consecutive adult patients with TBI (aged ≥ 15 years) and with a cerebral CT showing signs of trauma. Patient characteristics are presented in Table 1. Seventy per cent of the patients were men. The male preponderance was clear in patients aged 15–74 years, while among patients aged 75 years or older there was a gradual shift to a female preponderance. The median age was 58 years (range 15–98). The fractions of patients aged 65 years or older, 75 years or older, and 85 years or older were 39%, 20%, and 8%, respectively.
Increasing age was significantly associated with a higher comorbidity (ASA score 3–4) (p < 0.001), need for assistance in daily life (p < 0.001), and the use of antithrombotic medication (p < 0.001). Falls were the most frequent injury mechanism (55%), followed by motor vehicle accidents (10%), sports accidents (including bicycles) (9%), and violence/self-harm (10%). The proportion of fall-related injuries increased significantly with increasing age (p < 0.001) (Fig. 1).
Head injury severity
Mean GCS score, HISS severity grade, and Rotterdam CT-score for the different age groups are presented in Table 1. The mean GCS score and the fraction of mild TBI increased with increasing age (p < 0.03), indicating less severe TBI with increasing age. In contrast, the Rotterdam CT score showed a gradual increase with increasing age, indicating more severe injury in the higher age groups (p < 0.001). The fraction of patients with multiple trauma decreased with increasing age (p < 0.001).
Patient management
The trauma team was activated for initial triage in 77% of the patients, advanced TBI imaging was performed in 60%, ICP-monitoring was used in 24%, ventilator treatment was applied to 41%, surgical evacuation of intracranial mass lesion was done in 14%, and decompressive craniectomy was performed in 2% (Table 1).
TTA, advanced TBI imaging, invasive ICP monitoring, and ventilator treatment all declined significantly with increasing age (p < 0.001). There was no significant change in the rate of surgery with increasing age for mild and moderate TBI, but for severe TBI the age curve was parabola shaped, indicating a low rate of surgery in both young and elderly patients compared to the middle-aged patient group. Decompressive craniectomy was not performed in any patients ≥ 75 years. Figure 2 shows the effect of age on the management intensity (composite score). The graphs demonstrate that increasing age is associated with lower management intensity irrespective of head injury severity.
Mortality
OS analyses were conducted using Kaplan–Meier curves (Fig. 3). 30-day overall mortality was 12%. 30-day mortality in the age groups 15–54 years, 55–64 years, 65–74 years, 75–84 years and ≥ 85 years was 6%, 11%, 11%, 23% and 24%, respectively. Uni- and multivariate survival analyses were performed using logistic multinomial regression (Table 2). In the multivariate analyses, the following parameters had a significant association with an increased risk of death within 30 days of trauma: increasing age, moderate/severe TBI, Rotterdam CT-score ≥ 4, and low management intensity (composite score ≤ 3). Severe comorbidities (pre-injury ASA ≥ 3) approached a significance level (p = 0.069). Sex was not associated with 30-day survival.
| Table 1 Baseline patient characteristics for 1,571 patients by age groups | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 15-24yrs | 25-34yrs | 35-44yrs | 45-54yrs | 55-64yrs | 65-74yrs | 75-84yrs | ≥ 85yrs | |||||
| Count (n, %) | 179 (100) | 168 (100) | 153 (100) | 197 (100) | 258 (100) | 297 (100) | 197 (100) | 122 (100) | ||||
| Male sex (n, %) | 134 (74.9) | 134 (79.8) | 125 (81.7) | 145 (73.6) | 195 (75.6) | 201 (67.7) | 112 (56.9) | 46 (37.7) | ||||
| Pre-injury ASA-score (n, %) | ||||||||||||
| 1 | 165 (92.2) | 134 (79.8) | 102 (66.7) | 114 (57.9) | 72 (27.9) | 66 (22.2) | 18 (9.1) | 4 (3.3) | ||||
| 2 | 11 (6.1) | 26 (15.5) | 31 (20.3) | 45 (22.8) | 88 (34.1) | 127 (42.8) | 86 (43.7) | 30 (24.6) | ||||
| 3 | 3 (1.7) | 7 (4.2) | 20 (13.1) | 38 (19.3) | 97 (37.6) | 97 (32.7) | 91 (46.2) | 85 (69.7) | ||||
| 4 | 0 (0) | 1 (0.6) | 0 (0) | 0 (0) | 1 (0.4) | 7 (2.4) | 2 (1.0) | 3 (2.5) | ||||
| Pre-injury living (n, %) | ||||||||||||
| Independent | 176 (98.3) | 162 (96.4) | 147 (96.1) | 185 (93.9) | 236 (91.5) | 269 (90.6) | 155 (78.7) | 51 (41.8) | ||||
| Home with assistance | 1 (0.6) | 5 (3.0) | 4 (2.6) | 8 (4.1) | 20 (7.8) | 22 (7.4) | 29 (14.7) | 54 (44.3) | ||||
| Institutionalised | 2 (1.1) | 1 (0.6) | 2 (1.3) | 4 (2.0) | 2 (0.8) | 6 (2.0) | 13 (6.6) | 17 (13.9) | ||||
| Pre-injury antithrombotics (n, %) | ||||||||||||
| Anticoagulation | 1 (0.6) | 0 (0) | 5 (3.3) | 2 (1.0) | 14 (5.4) | 33 (11.1) | 52 (26.4) | 38 (31.1) | ||||
| Platelet inhibitor | 0 (0) | 0 (0) | 1 (0.7) | 10 (5.1) | 38 (14.7) | 87 (29.3) | 68 (34.5) | 45 (36.9) | ||||
| Platelet inhibitor + anticoagulation | 0 (0) | 0 (0) | 1 (0.7) | 1 (0.5) | 3 (1.2) | 7 (2.4) | 7 (3.6) | 2 (1.6) | ||||
| GCS mean | 10.0 | 11.0 | 11.1 | 11.0 | 11.2 | 11.8 | 11.4 | 12.5 | ||||
| HISS (n, %) | ||||||||||||
| Mild | 62 (34.6) | 83 (49.4) | 68 (44.4) | 81 (41.1) | 111 (43.0) | 134 (45.1) | 94 (47.7) | 73 (59.8) | ||||
| Moderate | 50 (27.9) | 32 (19.0) | 41 (26.8) | 58 (29.4) | 74 (28.7) | 100 (33.7) | 50 (25.4) | 32 (26.2) | ||||
| Severe | 67 (37.4) | 53 (31.5) | 44 (28.8) | 58 (29.4) | 73 (28.3) | 63 (21.2) | 53 (26.9) | 17 (13.9) | ||||
| Pathoanatomy (n, %) | ||||||||||||
| Skull fracture | 121 (67.6) | 107 (63.7) | 95 (62.1) | 125 (63.5) | 135 (52.3) | 133 (44.8) | 56 (28.4) | 36 (29.5) | ||||
| SDH | 72 (40.2) | 73 (43.5) | 65 (42.5) | 109 (55.3) | 169 (65.5) | 192 (64.6) | 133 (67.5) | 77 (63.1) | ||||
| tSAH | 80 (44.7) | 104 (61.9) | 93 (60.8) | 116 (58.9) | 170 (65.9) | 189 (63.6) | 118 (59.9) | 72 (59.0) | ||||
| EDH | 47 (26.3) | 35 (20.8) | 34 (22.2) | 36 (18.3) | 33 (12.8) | 28 (9.4) | 9 (4.6) | 5 (4.1) | ||||
| Brain contusion | 100 (55.8) | 82 (48.8) | 82 (53.6) | 102 (51.8) | 138 (53.5) | 137 (46.1) | 87 (44.2) | 48 (39.3) | ||||
| Rotterdam CT score (n, %) | ||||||||||||
| 1–2 | 103 (57.5) | 82 (48.8) | 60 (39.2) | 76 (38.6) | 83 (32.2) | 89 (30.0) | 44 (22.3) | 38 (31.1) | ||||
| 3–4 | 66 (36.9) | 67 (39.9) | 80 (52.3) | 101 (51.3) | 152 (58.9) | 182 (61.3) | 132 (67.0) | 73 (59.8) | ||||
| 5–6 | 10 (5.6) | 19 (11.3) | 13 (8.5) | 20 (10.2) | 23 (8.9) | 26 (8.8) | 21 (10.7) | 11 (9.0) | ||||
| Multiple trauma (n, %) | ||||||||||||
| No | 78 (43.6) | 74 (44.0) | 75 (49.0) | 75 (38.1) | 124 (48.1) | 170 (57.2) | 121 (61.4) | 82 (61.4) | ||||
| Yes | 101 (56.4) | 94 (56.0) | 78 (51.0) | 122 (61.9) | 134 (51.9) | 127 (42.8) | 76 (38.6) | 40 (32.8) | ||||
| Management intensity (n, %) | ||||||||||||
| TTA | 165 (92.2) | 140 (83.3) | 129 (84.3) | 167 (84.8) | 214 (82.9) | 205 (69.0) | 127 (64.5) | 69 (56.6) | ||||
| CTA/CTV/MRA/MRV | 112 (62.6) | 97 (57.7) | 84 (54.9) | 123 (62.4) | 164 (63.6) | 163 (54.9) | 84 (42.6) | 21 (17.2) | ||||
| MR | 90 (50.3) | 52 (31.0) | 52 (34.0) | 69 (35.0) | 75 (29.1) | 50 (16.8) | 21 (10.7) | 4 (3.3) | ||||
| Ventilator therapy | 97 (54.2) | 69 (41.1) | 65 (42.5) | 89 (45.2) | 119 (46.1) | 112 (37.7) | 69 (35.0) | 22 (18.0) | ||||
| ICP-monitor | 62 (34.6) | 40 (23.8) | 42 (27.5) | 59 (29.9) | 81 (31.4) | 59 (19.9) | 27 (13.7) | 3 (2.5) | ||||
| Evacuation of mass lesion | 18 (10.1) | 22 (13.1) | 27 (17.6) | 27 (13.7) | 43 (16.7) | 49 (16.5) | 20 (10.2) | 10 (8.2) | ||||
| Decompressive craniectomy | 4 (2.2) | 4 (2.4) | 6 (3.9) | 9 (4.6) | 4 (1.6) | 4 (1.3) | 0 (0) | 0 (0) | ||||
| ASA: American Society of Anesthesiologists, LOC: Loss of consciousness, GCS: Glasgow Coma Scale, HISS: Head Injury Severity Scale, SDH: Subdural haematoma, tSAH: Traumatic subarachnoidal haemorrhage, EDH: Epidural haematoma, TTA: Trauma team activation, CTA: Computed tomography angiography, CTV: Computed tomography venography, MRA: Magnetic resonance angiography, MRV: Magnetic resonance venography, MR: Magnetic resonance, ICP: Intracranial pressure monitor | ||||||||||||
Due to technical limitations, Table 2 is provided in the Supplementary Files section. Caption: Table 2: Uni- and multivariate Cox regression analyses of parameters potentially associated with risk of death within 30-days of trauma.