Division of Epidemiology and Biostatistics, Department of Public Health Sciences (Dr Selassie), Department of Health Science and Research, College of Health Professions (Drs Cao, Saunders, and Krause), and College of Medicine (Ms Church), Medical University of South Carolina, Charleston.
J Head Trauma Rehabil. 2014 May-Jun;29(3):E8-E19. doi: 10.1097/HTR.0b013e3182976ad3.
To determine the influence of preexisting heart, liver, kidney, cancer, stroke, and mental health problems and examine the influence of low socioeconomic status on mortality after discharge from acute care facilities for individuals with traumatic brain injury.
Population-based retrospective cohort study of 33695 persons discharged from acute care hospital with traumatic brain injury in South Carolina, 1999-2010.
Days elapsing from the dates of injury to death established the survival time (T). Data were censored at the 145th month. Multivariable Cox regression was used to examine the independent effect of the variables on death. Age-adjusted cumulative probability of death for each chronic disease of interest was plotted.
By the 70th month of follow-up, rate of death was accelerated from 10-fold for heart diseases to 2.5-fold for mental health problems. Adjusted hazard ratios for diseases of the heart (2.13), liver-renal (3.25), cancer (2.64), neurological diseases and stroke (2.07), diabetes (1.89), hypertension (1.43), and mental health problems (1.59) were highly significant (each with P < .001). Compared with persons with private insurance, the hazard ratio was significantly elevated with Medicaid (1.67), Medicare (1.54), and uninsured (1.27) (each with P < .001).
Specific chronic diseases strongly influenced postdischarge mortality after traumatic brain injury. Low socioeconomic status as measured by the type of insurance elevated the risk of death.
确定预先存在的心脏、肝脏、肾脏、癌症、中风和心理健康问题对创伤性脑损伤患者从急性护理机构出院后的死亡率的影响，并检查低社会经济地位的影响。
这是一项南卡罗来纳州 1999 年至 2010 年期间从急性护理医院出院的 33695 名创伤性脑损伤患者的基于人群的回顾性队列研究。
从损伤日期到死亡日期的天数确定了生存时间（T）。数据在第 145 个月被截尾。多变量 Cox 回归用于检查变量对死亡的独立影响。绘制了每个感兴趣的慢性疾病的年龄调整累积死亡率曲线。
在 70 个月的随访中，心脏病的死亡率从 10 倍加速到心理健康问题的 2.5 倍。调整后的心脏疾病（2.13）、肝-肾疾病（3.25）、癌症（2.64）、神经疾病和中风（2.07）、糖尿病（1.89）、高血压（1.43）和心理健康问题（1.59）的疾病危险比均具有统计学意义（均 P<.001）。与私人保险相比，医疗补助（1.67）、医疗保险（1.54）和无保险（1.27）的危险比显著升高（均 P<.001）。
特定的慢性疾病强烈影响创伤性脑损伤后的出院后死亡率。以保险类型衡量的低社会经济地位会增加死亡风险。
