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Peer-reviewedCC BY-NC-NDEmergency medicine Australasia : EMA

Moderate and Severe Traumatic Brain Injury Outcomes-A 20 Year (2002-2021) Analysis.

  • Yuewei Xiao1,2
  • Yesul Kim1,2
  • Gerard O'Reilly1,3,4
  • Jeffrey V Rosenfeld5
  • Madeline Green1,2
  • Ron Jithoo1,2,5
  • Jin Tee1,2,5
  • Noel Sceriha5
  • Andrew Udy6,7
  • Lara Kimmel3,8
  • Christopher Buntting5
  • Joseph Mathew1,2,9
1 more authors
  • Mark C Fitzgerald1,2,9
9 affiliations
  1. 1National Trauma Research Institute, Melbourne, Australia.
  2. 2School of Translational Medicine, Monash University, Melbourne, Australia.
  3. 3School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
  4. 4Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Australia.
  5. 5Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia.
  6. 6Department of Intensive Care & Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.
  7. 7Australian and New Zealand Intensive Care-Research Centre, Monash University, Melbourne, Australia.
  8. 8Allied Health, The Alfred Hospital, Melbourne, Australia.
  9. 9Trauma Service, The Alfred Hospital, Melbourne, Australia.
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Abstract

Objective

Although recognised as a leading cause of death and disability, it is unclear whether current treatment strategies have improved outcomes from blunt moderate to severe traumatic brain injuries (msTBI) due to a lack of available epidemiological data. This study sought to determine if in-hospital mortality and early functional outcomes of msTBI patients have changed over 20 years. Early functional outcomes were determined through the surrogate measure of the proportion of patients discharged directly to home.Methods

A longitudinal cohort study using The Alfred Health Trauma Registry data. Subjects were aged 16-70 years with blunt msTBI (Head Abbreviated Injury Scale 3-5) admitted to The Alfred Trauma Service between 1 January 2002 and 31 December 2021.Results

A total of 8222 patients presented with msTBI over the period, with 692 deaths (8.5%). Unadjusted in-hospital mortality decreased from 12.1% in 2002 to 4.0% in 2021 (OR 0.96, 95% CI 0.95-0.97, p < 0.001). Sensitivity analysis demonstrated a statistically significant reduction in the odds of death even after adjusting for injury severity (OR 0.96, 95% CI 0.93-0.99, p < 0.0001). The proportion of patients discharged to home increased from 30.6% to 60.8% over the period (OR 1.05, 95% CI 1.04-1.06, p < 0.001).Conclusion

There was a reduction in in-hospital mortality and an increase in the proportion discharged home for adults hospitalised with msTBI at The Alfred Hospital over the last two decades. These results foster optimism for the care of neurotrauma patients, but further research is required to identify the modifiable factors associated with these improved outcomes.

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Cite

BibTeXRIS
BibTeX
@article{xiao2026moderate,
  title = {{Moderate and Severe Traumatic Brain Injury Outcomes-A 20 Year (2002-2021) Analysis.}},
  author = {Yuewei Xiao and Yesul Kim and Gerard O'Reilly and Jeffrey V Rosenfeld and Madeline Green and Ron Jithoo and Jin Tee and Noel Sceriha and Andrew Udy and Lara Kimmel and Christopher Buntting and Joseph Mathew and Mark C Fitzgerald},
  journal = {Emergency medicine Australasia : EMA},
  year = {2026},
  month = oct,
  doi = {10.1111/1742-6723.70374},
  url = {https://europepmc.org/article/MED/42897986},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Moderate and Severe Traumatic Brain Injury Outcomes-A 20 Year (2002-2021) Analysis.
AU  - Yuewei Xiao
AU  - Yesul Kim
AU  - Gerard O'Reilly
AU  - Jeffrey V Rosenfeld
AU  - Madeline Green
AU  - Ron Jithoo
AU  - Jin Tee
AU  - Noel Sceriha
AU  - Andrew Udy
AU  - Lara Kimmel
AU  - Christopher Buntting
AU  - Joseph Mathew
AU  - Mark C Fitzgerald
PY  - 2026
DA  - 2026/10/01
JO  - Emergency medicine Australasia : EMA
DO  - 10.1111/1742-6723.70374
UR  - https://europepmc.org/article/MED/42897986
AB  - Objective  Although recognised as a leading cause of death and disability, it is unclear whether current treatment strategies have improved outcomes from blunt moderate to severe traumatic brain injuries (msTBI) due to a lack of available epidemiological data. This study sought to determine if in-hospital mortality and early functional outcomes of msTBI patients have changed over 20 years. Early functional outcomes were determined through the surrogate measure of the proportion of patients discharged directly to home.Methods  A longitudinal cohort study using The Alfred Health Trauma Registry data. Subjects were aged 16-70 years with blunt msTBI (Head Abbreviated Injury Scale 3-5) admitted to The Alfred Trauma Service between 1 January 2002 and 31 December 2021.Results  A total of 8222 patients presented with msTBI over the period, with 692 deaths (8.5%). Unadjusted in-hospital mortality decreased from 12.1% in 2002 to 4.0% in 2021 (OR 0.96, 95% CI 0.95-0.97, p < 0.001). Sensitivity analysis demonstrated a statistically significant reduction in the odds of death even after adjusting for injury severity (OR 0.96, 95% CI 0.93-0.99, p < 0.0001). The proportion of patients discharged to home increased from 30.6% to 60.8% over the period (OR 1.05, 95% CI 1.04-1.06, p < 0.001).Conclusion  There was a reduction in in-hospital mortality and an increase in the proportion discharged home for adults hospitalised with msTBI at The Alfred Hospital over the last two decades. These results foster optimism for the care of neurotrauma patients, but further research is required to identify the modifiable factors associated with these improved outcomes.
SN  - 1742-6731
SN  - 1742-6723
ER  -