Evidence map›Paper›PMID 41223046›Full record

ArticleMilitary medicine2026

Epidemiology and Outcomes of Battlefield-Related Penetrating and Closed Traumatic Brain Injuries Compared to Non-Head Injuries: A Retrospective Cohort Study.

Melissa R Meister, Jason H Boulter, Callum D Dewar, Caren Stuebe, Erica Sercy, M Leigh Carson, Faraz Shaikh, Joseph M Yabes, Laveta Stewart, David R Tribble and 2 more

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Article in Military medicine, 2026. 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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1 · What the graph read from it

What it found

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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Melissa R MeisterDivision of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, United States.ORCID 0009-0007-7833-9927
Jason H BoulterDepartment of Neurosurgery, Piedmont Atlanta Hospital, Atlanta, GA 30309, United States.
Callum D DewarDivision of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, United States.ORCID 0009-0001-1313-9816
Caren StuebeDivision of Neurosurgery, Inova Fairfax Medical Campus, Falls Church, VA 22042, United States.
Erica SercyInfectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.ORCID 0000-0002-7975-8601
M Leigh CarsonInfectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Faraz ShaikhInfectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Joseph M YabesInfectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234, United States.
Laveta StewartInfectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
David R TribbleInfectious Disease Clinical Research Program, Preventive Medicine & Biostatistics Department, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Viktor BartanuszThe Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, United States.
Bradley DenglerDivision of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, United States.

Funding

Defense Health ProgramDefense Health Program, U.S. Department of Defense HU0001190002Department of the NavyDepartment of the Navy under the Wounded, Ill, and Injured ProgramDepartment of WarInfectious Disease Clinical Research ProgramNational Institute of Allergy and Infectious DiseasesNational Institute of Allergy and Infectious Diseases, National Institute of Health Inter-Agency Agreement Y1-AI-5072National Institute of Health Y1-AI-5072NIAID NIH HHS Y01 AI005072The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.Uniformed Services University of the Health Sciences, Department of Preventive Medicine and BiostatisticsU.S. Department of Defense HU0001190002Wounded, Ill, and Injured Program
6 · The paper itself

Abstract

introductionTraumatic brain injuries (TBIs) are associated with substantial morbidity and mortality. We examined characteristics and outcomes among military personnel with battlefield-related penetrating TBI (pTBI) compared to closed TBI (cTBI) and non-head injuries (without cranial injuries). MATERIALS AND

methodsMilitary personnel admitted to participating U.S. military hospitals (2009-2014) were classified based on injury patterns: pTBI, cTBI (head Abbreviated Injury Scale [AIS] ≥3), and non-head (≥1 non-head injury AIS ≥3). Propensity score and inverse probability of treatment weighting (IPTW) were used to assess associations with mortality, hospital stay, and infection burden.

resultsThe study population included 106 pTBI patients, 259 cTBI patients, and 715 patients with non-head injuries. Patients with pTBIs were more severely injured with differing injury mechanisms compared to the other 2 groups. Patients with pTBIs had more critical care requirements versus both cTBI and non-head injury patients (P < .05) and longer hospitalization (median 27 days vs. 22; P = .041) compared to cTBI patients. More central nervous system (CNS) infections were diagnosed among patients with pTBIs (11.3%) versus cTBIs (1.2%) and non-head injuries (0.7%; P < .001). Although the overall proportion of patients who developed non-CNS infections was not significantly different between the TBI groups, there was a higher proportion among pTBI versus non-head injury patients (53.8% vs. 40.8%; P = .012). Patients with pTBIs also had less skin and soft-tissue infections and more pneumonia compared to non-head injury patients (P < .05). There was no significant difference in the proportion of mortality between the pTBI and cTBI patients (7.6% vs. 3.1%); however, it was higher compared to patients with non-head injuries (1.0%; P < .001). Sustaining any TBI (penetrating or closed) was associated with greater risk of mortality compared to non-head injuries (risk ratio: 3.71; 95% CI, 1.83-7.55).

conclusionsPatients with pTBIs are critically injured with substantial critical care requirements and morbidity. Between patients with pTBIs and cTBIs, there was not a significant difference in non-CNS infection burden or mortality, but pTBI patients did have longer hospitalization. When compared to severely injured military personnel with non-head injuries using propensity scores and IPTW analysis, sustaining a TBI (penetrating or closed) was not associated with having more non-CNS infections or a longer hospital stay. This may be a result of the high injury severity (median of 26) and relative occurrence of polytrauma in the total population. Patients with TBIs (penetrating or closed) did have a greater risk of mortality compared to patients with non-head injuries.

Indexed as

Brain Injuries, TraumaticAbbreviated Injury ScaleAdultCohort StudiesFemaleHumansLength of StayMaleMilitary PersonnelPropensity ScoreRetrospective StudiesUnited StatesWounds, Penetrating

Identifiers

PMID41223046
PMCPMC13012271

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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.