Long-term survival of traumatic brain injury and intra-cerebral haemorrhage patients: A multicentric observational cohort

• Published in: Journal of critical care 2024-10, Vol.83, p.154843, Article 154843
• Main Authors: Dantan, E., Foucher, Y., Simon-Pimmel, J., Léger, M., Campfort, M., Lasocki, S., Lakhal, K., Bouras, M., Roquilly, A., Cinotti, R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Brain Injuries, Traumatic - mortality; Brain Injuries, Traumatic - therapy; Cerebral Hemorrhage - mortality; Cohort Studies; Critical care; Female; Glasgow Coma Scale; Humans; Intensive Care Units - statistics & numerical data; Intra-cerebral haemorrhage; Length of stay; Length of Stay - statistics & numerical data; Life Sciences; Long term mortality; Male; Middle Aged; Mortality; Patients; Risk Factors; Santé publique et épidémiologie; Survival Analysis; Trauma; Traumatic brain injury; Variables; Ventilators
• ISSN: 0883-9441; 1557-8615; 1557-8615
• DOI: 10.1016/j.jcrc.2024.154843

Mortality is often assessed during ICU stay and early after, but rarely at later stage. We aimed to compare the long-term mortality between TBI and ICH patients. From an observational cohort, we studied 580 TBI patients and 435 ICH patients, admitted from January 2013 to February 2021 in 3 ICUs and alive at 7-days post-ICU discharge. We performed a Lasso-penalized Cox survival analysis. We estimated 7-year survival rates at 72.8% (95%CI from 67.3% to 78.7%) for ICH patients and at 84.9% (95%CI from 80.9% to 89.1%) for TBI patients: ICH patients presenting a higher mortality risk than TBI patients. Additionally, we identified variables associated with higher mortality risk (age, ICU length of stay, tracheostomy, low GCS, absence of intracranial pressure monitoring). We also observed anisocoria related with the mortality risk in the early stage after ICU stay. In this ICU survivor population with a prolonged follow-up, we highlight an acute risk of death after ICU stay, which seems to last longer in ICH patients. Several variables characteristic of disease severity appeared associated with long-term mortality, raising the hypothesis that the most severe patients deserve closer follow-up after ICU stay. •Comparing the long-term mortality between TBI and ICH patients after post-ICU discharge.•From the French cohort AtlanREA, we observed a poorer long-term survival for patients admitted for an ICH.•We highlighted an acute risk of death after ICU stay, which seems to last longer in ICH patients.•Disease severity variables appeared associated with long-term mortality.