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Brain injury : [BI] · Nov 2008
Long-term mortality trends in functionally-dependent adults following severe traumatic-brain injury.
- Ian J Baguley, Melissa T Nott, and Shameran Slewa-Younan.
- Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, Australia. ianb@biru.wsahs.nsw.gov.au
- Brain Inj. 2008 Nov 1; 22 (12): 919-25.
Primary ObjectiveTo investigate mortality trends in functionally dependent adults following traumatic brain injury (TBI).MethodsData for 966 consecutive admissions to a specialist TBI rehabilitation service were reviewed. Details for 69 subjects who were functionally dependent at rehabilitation discharge were cross-referenced against the State Government Death Register. The observed mortality rate was compared to an equivalent population sample derived from Australian Life Tables.ResultsTwenty-five subjects (36%) were deceased at an average 10.5 years post-injury (SD 5 years; range 1.7-18.8 years). The observed numbers of deaths far exceeded the expected population figure (1.9) for the same period (1989-2007) yielding a standardized mortality rate of 13.2. Mortality trends suggested a bimodal distribution, with more deaths in the first 5 years post-injury followed by no further deaths until 9 years post-injury.ConclusionsMortality in this functionally-dependent group was significantly associated with age, male sex and degree of disability at discharge. The bimodal distribution of mortality data suggests different contributory mechanisms to early vs. late mortality in this group.
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