ArticleClinical and experimental emergency medicine2025
Impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated traumatic brain injury.
Article in Clinical and experimental emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTraumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study evaluates the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI.
methodsThis retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) for 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022. Patients were categorized into isolated TBI group (iTBI; n=127,673) and non-isolated TBI group (niTBI; n=52,385) based on injury diagnostic codes. Clinical outcomes-24-hour and 30-day mortality, hospital admission, and interhospital transfer-were compared. Multivariate logistic regression analyses adjusted for potential confounders were performed.
resultsThe niTBI patients exhibited significantly higher 24-hour mortality (1.5% vs. 0.4%), 30-day mortality (2.6% vs. 1.0%), hospital admissions (24.5% vs. 8.4%), and interhospital transfers (3.6% vs. 1.1%) than iTBI patients (all P<0.001). Concomitant injuries increased the adjusted odds of 24-hour mortality (adjusted odds ratio [aOR], 1.456; 95% confidence interval [CI], 1.286-1.648) and 30-day mortality (aOR, 1.111; 95% CI, 1.022-1.208). Thoracic injuries were the most significant predictor of adverse outcomes in niTBI patients, increasing the odds of 24-hour mortality by nearly sixfold (aOR, 5.958; 95% CI 5.057-7.019).
conclusions: Concomitant injuries significantly worsen clinical outcomes in TBI patients, with thoracic injuries being the most critical predictor of mortality. These findings highlight the importance of comprehensive trauma assessments and targeted prevention strategies to improve survival rates and optimize resource allocation for patients with multiple injuries.
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