ArticleCanadian journal of surgery. Journal canadien de chirurgie
Association of age with death and withdrawal of life-sustaining therapy after severe traumatic brain injury.
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Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7citing papers in PubMed
4.5field-weighted citation impact, top 5% of its field
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Multidimensional Preinjury Health and 6-month Outcome After Traumatic Brain Injury in Older Adults Presenting With Mainly GCS 13-15.The Journal of head trauma rehabilitation · 2026Article
- The ethics of blood stewardship and quantitative futility assessments to predict certain death in neurotrauma patients.Frontiers in medicine · 2026Review
- Machine Learning Reveals Demographic Disparities in Palliative Care Timing Among Patients With Traumatic Brain Injury Receiving Neurosurgical Consultation.Neurocritical care · 2025Article
- Consensus on the management of traumatic brain injury in older adults: Results from a Delphi study.Brain & spine · 2025Article
- Clinical outcomes and end-of-life treatment in 596 patients with isolated traumatic brain injury: a retrospective comparison of two Dutch level-I trauma centers.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Traumatic Brain Injury as an Independent Predictor of Futility in the Early Resuscitation of Patients in Hemorrhagic Shock.Journal of clinical medicine · 2024Review
- Factors influencing withdrawal of life-sustaining treatments in patients with severe acquired brain injuries: a scoping review.Frontiers in neurologyReview
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Authors and funding
16 authors at 1 institution in 1 country.
Alexandre TranFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji) aletran@toh.ca.
Victoria SaigleFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Neraj ManhasFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Lauralyn McIntyreFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Alexis F TurgeonFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
François LauzierFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Michael ChasséFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Colleen GolkaFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Scott J MillingtonFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Kwadwo KyeremantengFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Diana GhindaFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Howard LesiukFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Salmaan KanjiFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Jennifer FairbairnFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Tammy LloydFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
Shane W EnglishFrom the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Tran, Saigle, McIntyre, Kanji, English); the Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ont. (Tran, McIntyre, Golka, Millington, Kyeremanteng, Kanji, Fairbairn, Lloyd, English); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Tran, Ghinda, Lesiuk); the Department of Surgery, University of British Columbia, Vancouver, BC (Manhas); the Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Que. (Turgeon, Lauzier); the Department of Medicine, Université Laval, Québec, Que. (Lauzier); the CHU de Québec-Université Laval Research Centre, Population Health and Optimal Health Practices Unit, Trauma - Emergency - Critical Care Medicine, Québec, Que. (Turgeon); the Innovation Hub, Centre hospitalier de l'Université de Montréal Research Centre, Montréal, Que. (Chassé); and the Department of Pharmacy, University of Ottawa, Ottawa, Ont. (Kanji).
University of British Columbia · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCompared to younger age, older age (≥ 65 yr) is associated with worse outcomes after severe traumatic brain injury (TBI). We sought to describe the association of older age with in-hospital death and aggressiveness of intervention.
methodsWe conducted a retrospective cohort study of adult (age ≥ 16 yr) patients with severe TBI admitted to a single academic tertiary care neurotrauma centre between January 2014 and December 2015. We collected data through chart review as well as from our institutional administrative database. We provided descriptive statistics and used multivariable logistic regression to evaluate the independent association of age with the primary outcome, in-hospital death. The secondary outcome was early withdrawal of life-sustaining therapy.
resultsThere were 126 adult patients (median age 67 yr [Q1-Q3, 33-80 yr]) with severe TBI during the study period who met our eligibility criteria. The most common mechanism was high-velocity blunt injury (55 patients [43.6%]). The median Marshall score was 4 (Q1-Q3, 2-6), and the median Injury Severity Score was 26 (Q1-Q3, 25-35). After controlling for confounders including clinical frailty, pre-existing comorbidity, injury severity, Marshall score and neurologic examination at admission, we observed that older patients were more likely than younger patients to die in hospital (odds ratio 5.10, 95% confidence interval 1.65-15.78). Older patients were also more likely to experience early withdrawal of life-sustaining therapy and less likely to receive invasive interventions.
conclusionAfter controlling for confounding factors relevant to older patients, we observed that age was an important and independent predictor of in-hospital death and early withdrawal of life-sustaining therapy. The mechanism by which age influences clinical decision-making independent of global and neurologic injury severity, clinical frailty and comorbidities remains unclear.
Indexed as
Brain Injuries, TraumaticFrailtyAdultAgedHospital MortalityHumansRetrospective StudiesWithholding Treatment
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