Predictors of Mortality and Functional recovery after severe traumatic brain injury: protocol for a prospective cohort study

Authors

  • Jessica Vaz Gonçalves a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Rodrigo Miranda Groberio a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Ramon da Silva Pereira a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Lucas Rodrigues Nascimento b Laboratório Caminhar, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Walter Gomes da Silva a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Hellen Siler Vasconcellos a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Carla Bernardo Louzada a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Larissa Cunha Silva Santos Ramos a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Thais da Silva Rodrigues a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Hanna Souza de Almeida a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;
  • Fernando Zanela da Silva Arêas a Laboratório de Neurorreabilitação e Neuromodulação, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil; b Laboratório Caminhar, Programa de Pós-graduação em Ciências Fisiológicas, Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil;

DOI:

https://doi.org/10.36311/jhgd.v33.14929

Keywords:

traumatic brain injury, mortality, Keywords: Resistance exercise, water aerobics, functionality and old age., predictors, protocol

Abstract

Introduction: traumatic brain injury is a global public health problem due to its severity and high rates of morbimortality worldwide. Identifying predictors associated with increased mortality and unfavorable functional outcomes after the traumatic brain injury event is crucial for minimizing morbidity and mortality rates. Therefore, this study aims to establish a protocol to investigate the predictors of mortality and functional recovery after severe traumatic brain injury in Brazil.

Methods: The study will include all patients admitted for severe traumatic brain injury (Glasgow Coma Scale ≤ 8) at the State Hospital of Urgency and Emergency, which is the referral trauma hospital of Espirito Santo. The outcomes of interest are hospital mortality and functional recovery 24 months after hospital discharge. Subjects will be followed up at seventy-two hours, three months, six months, twelve months, and twenty-four months after the trauma. Morbidity will be determined by assessing: 1) the level of motor and cognitive disability, 2) functional impairment and quality of life, and 3) aspects of rehabilitation treatment. Additionally, the traumatic brain injury load, estimated by the years of life lost, will be calculated.

Discussion: the results of this study will help identify variables that can predict morbidity and mortality, as well as diagnostic and therapeutic targets for patients with severe traumatic brain injury. Furthermore, the findings will have practical implications for: 1) the development of public policies, 2) investments in hospital infrastructure 3) understanding the socioeconomic impact of functional loss in the individuals.

Study registration: the study received approval from the Ethics Committee of the Federal University of Espirito Santo under protocol number 4.222.002 on August 18, 2020.

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References

Areas FZ, Schwarzbold ML, Diaz AP, Rodrigues IK, Sousa DS, Ferreira CL, Quevedo J, Lin K, Kupek E, Ritter C, Dal Pizzol F, Walz R. Predictors of Hospital Mortality and the Related Burden of Disease in Severe Traumatic Brain Injury: A Prospective Multicentric Study in Brazil. Front Neurol. 2019;25;10:432.

Magalhães ALG, Barros JLVM, Cardoso MGF, Rocha NP, Faleiro RM, Souza LC, Miranda AS, Teixeira AL. Traumatic brain injury in Brazil: an epidemiological study and systematic review of the literature. Arq Neuropsiquiatr. 2022;80(4):410-423.

Areas, FZS, Gonçalves, JV . Traumatismo Crânio encefálico no Brasil: Uma silenciosa e devastadora epidemia. Rev Bras Pesq Saude, v. 26, p. 6, 2022

Réa-Neto Á, da Silva Júnior ED, Hassler G, Dos Santos VB, Bernardelli RS, Kozesinski-Nakatani AC, Martins-Junior MJ, Reese FB, Cosentino MB, Oliveira MC, Teive HAG. Epidemiological and clinical characteristics predictive of ICU mortality of patients with traumatic brain injury treated at a trauma referral hospital - a cohort study. BMC Neurol. 2023;23(1):101.

Adamovich-Zeitlin R, Wanda PA, Solomon E, et al. Biomarkers of memory variability in traumatic brain injury. Brain Commun. 2020;3(1):202.

Dever A, Powell D, Graham L, et al. Gait Impairment in Traumatic Brain 76 Injury: A Systematic Review. Sensors (Basel). 2022;22(4):1480.

McDonald S, Genova H. The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood. Handb Clin Neurol. 2021;183:235-260.

Saint-Jean M, Allain P, Besnard J. A sociocognitive approach to social problem solving in patients with traumatic brain injury: a pilot study. Brain Inj. 2019;33(1):40-47.

Kaur P, Sharma S. Recent Advances in Pathophysiology of Traumatic Brain Injury. Curr Neuropharmacol. 2018;16(8):1224-1238.

Pavlovic D, Pekic S, Stojanovic M, Popovic V. Traumatic brain injury: neuropathological, neurocognitive and neurobehavioral sequelae. Pituitary. 2019 Jun;22(3):270-282.

Frattalone AR, Ling GS. Moderate and severe traumatic brain injury: pathophysiology and management. Neurosurg Clin N Am. 2013 Jul;24(3):309-19.

Blaylock RL, Maroon J. Immunoexcitotoxicity as a central mechanism in chronic traumatic encephalopathy-A unifying hypothesis. Surg Neurol Int. 2011;2:107.

Witcher KG, Bray CE, Chunchai T, et al. Traumatic Brain Injury Causes Chronic Cortical Inflammation and Neuronal Dysfunction Mediated by Microglia. J Neurosci. 2021;41(7):1597-1616.

Wang KK, Yang Z, Zhu T, et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury. Expert Rev Mol Diagn. 2018;18(2):165-180.

O’leary RA, Nichol AD. Pathophysiology of severe traumatic brain injury. J Neurosurg Sci. 2018;62(5):542-548.

Frattalone AR, Ling GS. Moderate and severe traumatic brain injury: pathophysiology and management. Neurosurg Clin N Am. 2013;24(3):309-19.

Chen T, Liu WB, Ren X, Li YF, Li W, Hang CH, Wang YH. Whole Body Vibration Attenuates Brain Damage Dev and Neuroinflammation Following Experimental Traumatic Brain Injury. Front Cell Biol. 2022;10:847859.

Junior JR, Welling LC, Schafranski M, Yeng LT, do Prado RR, Koterba E, de Andrade AF, Teixeira MJ, Figueiredo EG. Prognostic model for patients with traumatic brain injuries and abnormal computed tomography scans. J Clin Neurosci. 2017;42:122-128.

MRC CRASH Trial Collaborators; Perel P, Arango M, Clayton T, Edwards P, Komolafe E, Poccock S, Roberts I, Shakur H, Steyerberg E, Yutthakasemsunt S. Predicting outcome after traumatic brain injury: practical prognostic models based on large cohort of international patients. BMJ. 2008;336(7641):425-9.

Eagle SR, Pease M, Nwachuku E, Deng H, Okonkwo DO. Prognostic Models for Traumatic Brain Injury Have Good Discrimination but Poor Overall Model Performance for Predicting Mortality and Unfavorable Outcomes. Neurosurgery. 2023;1;92(1):137-143.

Bossers SM, van der Naalt J, Jacobs B, Schwarte LA, Verheul R, Schober P. Faceto-Face Versus Telephonic Extended Glasgow Outcome Score Testing After Traumatic Brain Injury. J Head Trauma Rehabil. 2021;01;36(3):134-138.

Pettigrew LE, Wilson JT, Teasdale GM. Reliability of ratings on the Glasgow Outcome Scales from in-person and telephone structured interviews. J Head Trauma Rehabil. 2003;18(3):252-8.

Wilson L, Boase K, Nelson LD, Temkin NR, Giacino JT, Markowitz AJ, Maas A, Menon DK, Teasdale G, Manley GT. A Manual for the Glasgow Outcome ScaleExtended Interview. J Neurotrauma. 20211;38(17):2435-2446.

Bilgi K, Gopalakrishna KN, Chakrabarti D, Rao GSU. Outcome Prediction of TBI: Are There Parameters That Affect the IMPACT and CRASH Models? World Neurosurg. 2021;146:590-596.

Steyerberg EW, Mushkudiani N, Perel P, Butcher I, Lu J, McHugh GS, Murray GD, Marmarou A, Roberts I, Habbema JD, Maas AI. Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics. PLoS Med. 2008;5(8):165.

Gao G, Wu X, Feng J, Hui J, Mao Q, Lecky F, Lingsma H, Maas AIR, Jiang J; China CENTER-TBI Registry Participants. Clinical characteristics and outcomes in patients with traumatic brain injury in China: a prospective, multicentre, longitudinal, observational study. Lancet Neurol. 2020;19(8):670-677.

Bonow RH, Barber J, Temkin NR, Videtta W, Rondina C, Petroni G, Lujan S, Alanis V, La Fuente G, Lavadenz A, Merida R, Jibaja M, Gonzáles L, Falcao A, Romero R, Dikmen S, Pridgeon J, Chesnut RM; Global Neurotrauma Research Group. The Outcome of Severe Traumatic Brain Injury in Latin America. World Neurosurg. 2018;111:82-90.

Bertotti MM, Martins ET, Arêas FZS, Vascouto HD, Rangel NB, Melo HM, Lin K, Kupek E, Pizzol FD, Walz R. Glasgow coma scale pupil score (GCS-P) and the hospital mortality in severe t traumatic brain injury: analysis of 1,066 Brazilian patients. Arq Neuropsiquiatr. 2023; 81:452-459

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Published

2023-08-14

Issue

Vol. 33 No. 2 (2023)

Section

ORIGINAL ARTICLES

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Copyright (c) 2023 Gonçalves JV, Pereira RS, Groberio RM, Nascimento LR, Silva WG, Vasconcellos HS, Louzada CB, Ramos LCSS, Rodrigues TS, Almeida HS, Arêas FZS

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This work is licensed under a Creative Commons Attribution 4.0 International License.