Evidence map›Paper›PMID 39562389›Full record

Observational studyNeurocritical care2025

Long-Term Outcomes After Severe Acute Brain Injury Requiring Mechanical Ventilation: Recovery Trajectories Among Patients and Mental Health Symptoms of Their Surrogate Decision Makers.

Natalie L Smith, Adrienne James, Nassim Matin, Christine T Fong, Monisha Sharma, Abhijit V Lele, Chiara Robba, Nicole Mazwi, Diana B Wiseman, Robert H Bonow and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Natalie L SmithDepartment of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA. ns3824@cumc.columbia.edu.ORCID 0000-0003-1646-6043
Adrienne JamesDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Nassim MatinDepartment of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Christine T FongDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Monisha SharmaDepartment of Global Health, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Abhijit V LeleDepartment of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Chiara RobbaDepartments of Anesthesia and Intensive Care, Policlinico San Martino, Genoa, Italy.
Nicole MazwiDepartment of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Diana B WisemanDepartment of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Robert H BonowDepartment of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Erin K KrossDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Claire J CreutzfeldtDepartment of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA.
James Town *Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Sarah Wahlster *Department of Neurology, Harborview Medical Center, University of Washington, Seattle, WA, USA.

Funding

University of Washington Harborview Medical Center Harborview Pilot Grant
6 · The paper itself

Abstract

backgroundLong-term outcomes of patients with severe acute brain injury (SABI) and their surrogate decision makers (SDMs) are insufficiently explored.

methodsWe conducted a prospective, single-center, observational study of patients with SABI who required mechanical ventilation between September and November 2021. Two telephonic interviews were conducted at 6-12 months and 18-24 months post SABI. Patients' functional outcomes at both time points were measured on the Glasgow Outcome Scale-Extended and categorized as dead (1), dependent (2-4), or independent (5-8). SDMs were interviewed at 18-24 months using validated screening tools for depression, anxiety, and posttraumatic stress disorder and qualitative questions about the hardest challenges during their recovery journey.

resultsWe included 103 patients (median age 58 years, 28% female, 77% White, 51% with stroke, 49% with traumatic brain injury); in-hospital mortality was 46%. At 6-12 months and 18-24 months, 34% and 36% were independent, respectively; the Glasgow Outcome Scale-Extended score improved ≥ 1 point for 32% between time points. Quality of life was perceived as acceptable for 47% of all survivors and 58% of independent patients by their SDMs. At 18-24 months, we reached 56 SDMs (median age 58 years, 71% female, 72% White). Symptoms of depression, anxiety, and posttraumatic stress disorder were reported in 18%, 30%, and 7%, respectively (23%, 34%, and 9% in the 35 SDMs of survivors and 10%, 24%, and 5% in the 21 SDMs to deceased patients). Main themes about challenges for patients and SDMs included extrinsic factors related to the health care system, and intrinsic factors related to the brain injury: difficulties in adapting to a new state, mental health symptoms, and social isolation.

conclusionsMental health symptoms among SDMs of patients with SABI were frequent at 18-24 months, and the patients' quality of life was deemed unacceptable for 42% of SDMs to independent survivors. Our findings underscore the need for psychosocial support to SDMs, the importance of addressing modifiable barriers to patient and SDM well-being, and the need for more patient/family-centric outcome measures.

Indexed as

Brain InjuriesDecision MakingRespiration, ArtificialAdultAgedAnxietyDepressionFemaleGlasgow Outcome ScaleHumansMaleMiddle AgedProspective StudiesRecovery of FunctionStress Disorders, Post-TraumaticAcute brain injuryCritical care outcomesPatient-reported outcome measures

Identifiers

PMID39562389

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.