Articles: traumatic-brain-injuries.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2023
Association of obesity with mild traumatic brain injury symptoms, inflammatory profile, quality of life and functional outcomes: a TRACK-TBI Study.
Obesity is associated with chronic inflammation, which may impact recovery from mild traumatic brain injury (mTBI). The objective was to assess the role of obesity in recovery of symptoms, functional outcome and inflammatory blood biomarkers after mTBI. ⋯ Obesity is associated with higher symptomatology at 6 and 12 months and higher concentrations of blood inflammatory markers throughout recovery following mTBI.
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Considering the disproportionate burden of delayed traumatic brain injury (TBI) management in low- and middle-income countries (LMICs), there is pressing demand for investigations. Therefore, our study aims to evaluate factors delaying the continuum of care for the management of TBIs in LMICs. ⋯ Several factors, both before and during hospitalization contribute to delays in the management of TBIs in LMICs. Strategically addressing these factors can help overcome delays and improve TBI management in LMICs.
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Journal of neurosurgery · Dec 2023
Predicting traumatic brain injury outcomes using a posterior dominant rhythm.
Predicting severe traumatic brain injury (sTBI) outcomes is challenging, and existing models have limited applicability to individual patients. This study aimed to identify metrics that could predict recovery following sTBI. The researchers strived to demonstrate that a posterior dominant rhythm on electroencephalography is strongly associated with positive outcomes and to develop a novel machine learning-based model that accurately forecasts the return of consciousness. ⋯ A PDR on EEG in sTBI patients predicts favorable outcomes. The authors' prognostic model has strong accuracy in predicting these outcomes, and performed better than previously reported models. The authors' model can be valuable in clinical decision-making as well as counseling families following these types of injuries.
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Journal of neurosurgery · Dec 2023
Observational StudyReal-world benefit of intracranial pressure monitoring in the management of severe traumatic brain injury: a propensity score matching analysis using a nationwide inpatient database.
Intracranial pressure (ICP) monitoring is recommended for the management of severe traumatic brain injury (TBI). The clinical benefit of ICP monitoring remains controversial, however, with randomized controlled trials showing negative results. Therefore, this study investigated the real-world impact of ICP monitoring in managing severe TBI. ⋯ ICP monitoring was associated with lower in-hospital mortality in the real-world management of severe TBI. The results suggest that active ICP monitoring is associated with improved outcomes after TBI, while the indication for monitoring might be limited to the most severely ill patients.
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Early-onset ventilator-associated pneumonia (VAP) is associated with poor outcomes in patients with severe traumatic brain injury (TBI). The primary aim of this study was to describe VAP, including the microbiology of VAP and differences in frequency of VAP when various definitions are applied. The secondary aim was to determine the clinical variables associated with the development of VAP in children with severe TBI. ⋯ Ventilator-associated pneumonia occurs commonly in children with severe TBI, with rates of 27-41%, depending on CDC-defined VAP or clinical VAP. The discrepancy between clinical VAP and CDC-defined VAP further illustrates the need for a standardized definition for VAP. Although most interventions were not associated with VAP, nebulized 3% saline and albuterol were associated with reduced incidence of VAP; future investigation is needed to determine whether mucolytic agents can decrease the rate of VAP in children with severe TBI.