Clinical outcomes and end-of-life treatment in 596 patients with isolated traumatic brain injury: a retrospective comparison of two Dutch level-I trauma centers

Purpose With an increasingly older population and rise in incidence of traumatic brain injury (TBI), end-of-life decisions have become frequent. This study investigated the rate of withdrawal of life sustaining treatment (WLST) and compared treatment outcomes in patients with isolated TBI in two Dut...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2024-08, Vol.50 (4), p.1249-1259
Main Authors: Niemeyer, Menco J. S., Jochems, Denise, Van Ditshuizen, Jan C., de Kanter, Janneke, Cremers, Lotte, van Hattem, Martijn, Den Hartog, Dennis, Houwert, Roderick Marijn, Leenen, Luke P. H., van Wessem, Karlijn J. P.
Format: Article
Language:English
Subjects:
Abbreviated Injury Scale
Adult
Aged
Anesthesia
Brain Injuries, Traumatic - therapy
Clinical outcomes
Cohort analysis
Critical Care Medicine
Emergency Medicine
Female
Glasgow Coma Scale
Hospital Mortality
Humans
Intensive
Male
Medicine
Medicine & Public Health
Middle Aged
Netherlands - epidemiology
Original
Original Article
Retrospective Studies
Sports Medicine
Surgery
Surgical Orthopedics
Terminal Care
Trauma
Trauma Centers
Traumatic brain injury
Traumatic Surgery
Withholding Treatment
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Summary:Purpose With an increasingly older population and rise in incidence of traumatic brain injury (TBI), end-of-life decisions have become frequent. This study investigated the rate of withdrawal of life sustaining treatment (WLST) and compared treatment outcomes in patients with isolated TBI in two Dutch level-I trauma centers. Methods From 2011 to 2016, a retrospective cohort study of patients aged ≥ 18 years with isolated moderate-to-severe TBI (Abbreviated Injury Scale (AIS) head ≥ 3) was conducted at the University Medical Center Rotterdam (UMC-R) and the University Medical Center Utrecht (UMC-U). Demographics, radiologic injury characteristics, clinical outcomes, and functional outcomes at 3–6 months post-discharge were collected. Results The study population included 596 patients (UMC-R: n  = 326; UMC-U: n  = 270). There were no statistical differences in age, gender, mechanism of injury, and radiologic parameters between both institutes. UMC-R patients had a higher AIShead (UMC-R: 5 [4–5] vs. UMC-U: 4 [4–5], p  
ISSN:1863-9933
1863-9941
1863-9941
DOI:10.1007/s00068-023-02407-5