Life | Special Issue : Traumatic Brain Injury: Epidemiology, Diagnosis, Treatment and Biomarkers

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Traumatic Brain Injury: Epidemiology, Diagnosis, Treatment and Biomarkers

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Dear Colleagues,

Traumatic brain injury is a major cause of morbidity and mortality throughout the world. Among persons younger than 45 years old, injury is the major cause of death, and TBI is the major cause of injury.

That said, the epidemiology of human traumatic brain injury is something of a moving target. It is unknown what proportion of those experiencing a TBI—of any severity—present for medical assessment. Even in industrialized countries with reasonably good methods of data gathering, no central registry can expect to capture more cases than those coded appropriately and systematically surveyed. The best one can do is to enumerate such known cases.

The epidemiology of TBI also varies by subpopulations. Infantile, pediatric, teen, adult, and elderly cases occur due to different circumstances and may have different outcomes. Sex, race, socioeconomic level, and other factors influence the incidence of both initial and recurrent injuries.

The goal of this Special Issue is to compile expert reviews regarding the epidemiology of TBI. Insofar as possible, specific data will be examined with respect to the differing epidemiology in important subpopulations. A secondary goal is to identify predictors of outcome, for instance, clinical and biomarker factors that appear to anticipate the patient’s long-term prognosis.

Dr. Jeff Victoroff
Dr. Alfredo Conti
Guest Editors

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14 pages, 609 KiB

Open AccessArticle

Correlating Various Clinical Outcomes and Associated Dispositions in Patients with Severe Traumatic Brain Injury (TBI)

by Bharti Sharma, Tirth Patel, Sarah Dawson-Moroz, George Agriantonis, Munirah Hasan, Navin D. Bhatia, Carrie Garcia, Praise Nesamony, Jasmine Dave, Juan Mestre, Shalini Arora, Saad Bhatti, Zahra Shafaee, Suganda Phalakornkul, Kate Twelker and Jennifer Whittington

Life 2025, 15(8), 1262; https://doi.org/10.3390/life15081262 - 8 Aug 2025

Viewed by 213

Abstract

Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Patient disposition following TBI has been shown to interact with factors such as age, sex, and injury severity to impact clinical outcomes. Discharge home is associated with better functional outcomes and lower mortality, while discharge to rehabilitation or long-term care facilities is linked to greater injury severity, older age, and higher comorbidity burden. The aim of this study was to further correlate clinical outcomes with discharge disposi-tions in patients with severe TBI. Methods: This is a retrospective study (2020–2023) of dispositions in patients with severe TBI with AIS (head) ≥ 3. We investigated the relationship between patient disposition and a range of clinical variables, using both parametric (ANOVA) and non-parametric (Kruskal–Wallis, Wilcoxon, Van der Waerden, Savage, Kolmogorov–Smirnov, and Cramer–von Mises) statistical tests. Variables significant in univariate analysis were entered into a multinomial logistic regression model, with discharge home as the reference group. Results: In a cohort of 824 patients, 25.1% were female (n = 207) and 74.9% were male (n = 617). The mean age was 64.1 years for females and 48.9 years for males. Those admitted for severe TBI were included in our analysis. Most patients were discharged home (52.8%), followed by death (12.4%), inpatient rehab (5.1%), and home with services (5.6%). Significant associations were found between disposition and sex, with both males and females most likely to be discharged home (p = 0.0174), as well as between disposition and injury type (p = 0.0186). Disposition was significantly associated with most major clinical variables: hospital length of stay (HLOS), vent days, Glasgow Coma Scale (GCS), and Injury Severity Score (ISS), with p-values < 0.0001 for ANOVA and non-parametric tests. Longer HLOS and ICULOS were associated with discharge to skilled nursing facilities (SNF) most frequently. Days on mechanical ventilation correlated most strongly with discharge to SNF. Lower GCS scores and higher AIS and ISS scores were linked to death or brain death. Prolonged EDLOS was predominantly associated with psychiatric admissions. Higher levels of ETOH were associated with discharge to police custody, followed by homelessness. Conclusions: Our study supports existing evidence that discharge disposition following severe TBI is influenced by several factors, such as injury severity, age, sex, and clinical variables, such as length of stay and ventilator days. Full article

(This article belongs to the Special Issue Traumatic Brain Injury: Epidemiology, Diagnosis, Treatment and Biomarkers)

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