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      Platelet levels and age are determinants of survival after mild–moderate TBI: A prospective study in Spain

      brief-report

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          Abstract

          Introduction

          Traumatic brain injury (TBI) is a very important reason for consultation in emergency departments.

          Methods

          A hospital cohort study with patients who attended a hospital emergency department between June 1, 2018 and December 31, 2020 due to TBI was studied. Clinical and sociodemographic variables were recorded. The levels of biomarkers and management variables were used. Qualitative variables were analyzed using Pearson's chi-square test, and quantitative variables using the Mann–Whitney U-test. Survival analyses were performed by fitting a multivariable Cox regression model for patient survival during the follow-up of the study in relation to the patient's characteristics upon admission to the emergency department.

          Results

          A total of 540 patients were included. The mean age was 83 years, and 53.9% of the patients were men. Overall, 112 patients (20.7%) died during the study follow-up. The mortality rate per 100 person-years was 14.33 (11.8–17.24), the most frequent mechanism being falls in the home, with none caused on public roads. The multivariable Cox proportional hazards model showed that survival after TBI was significantly associated with age, S100 levels, Charlson index, patient's institutionalized status, the place where the TBI occurred, and hemoglobin and platelet levels.

          Discussion

          The most common profile for a patient with a TBI was male and aged between 80 and 90 years. The combination of the variables age, Charlson index, place of TBI occurrence, and hemoglobin and platelet levels could offer early prediction of survival in our population independently of TBI severity. With the data obtained, a therapeutic algorithm could be established for patients suffering from mild TBI, allowing the patient to be supervised at home, avoiding futile referrals to emergency services.

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          Feature Selection with theBorutaPackage

          Miron B. Kursa, Witold Rudnicki (2010)
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            Proportional hazards tests and diagnostics based on weighted residuals

            PATRICIA GRAMBSCH, Terry Therneau (1994)
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              R: A Language and Environment for Statistical Com- puting

              (2022)
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 20 March 2023
                Publication date Collection: 2023
                Volume: 11
                Electronic Location Identifier: 1109426
                Affiliations
                [1] 1ERLab Emergency Research Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida , Lleida, Spain
                [2] 2Faculty of Medicine, University of Lleida , Lleida, Spain
                [3] 3Clinical Laboratory, University Hospital Arnau de Vilanova , Lleida, Spain
                [4] 4Systems Biology and Statistical Methods for Biomedical Research Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida , Lleida, Spain
                [5] 5Neurosciences Group, Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Universitat de Lleida , Lleida, Spain
                Author notes

                Edited by: Ottavia Eleonora Ferraro, University of Pavia, Italy

                Reviewed by: Maria Papadakaki, Hellenic Mediterranean University, Greece; Cristina Crocamo, University of Milano Bicocca, Italy; Paola Borrelli, University of Studies G. d'Annunzio Chieti and Pescara, Italy

                *Correspondence: Oriol Yuguero oriol.yuguero@ 123456udl.cat

                This article was submitted to Disaster and Emergency Medicine, a section of the journal Frontiers in Public Health

                Article
                DOI: 10.3389/fpubh.2023.1109426
                PMC ID: 10067594
                PubMed ID: 37020814
                SO-VID: f3edacce-de7c-4f23-a8ae-cfafffd137c6
                Copyright © Copyright © 2023 Yuguero, Vena, Bernal, Martínez-Alonso, Farre and Purroy.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 27 November 2022
                Date accepted : 14 February 2023
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 35, Pages: 9, Words: 5774
                Funding
                Funded by: Fundación Mutua Madrileña, doi 10.13039/100008061;
                Funded by: Roche Diagnostics, doi 10.13039/100016545;
                This work was supported by Fundación Mutua Madrileña and Roche Diagnostics.
                Categories
                Subject: Public Health
                Subject: Brief Research Report

                Keywords: tbi,survival,geriatric,emergency,falls
                Data availability:
                Keywords: tbi, survival, geriatric, emergency, falls

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