Predictive Factors of Return Home and Return to Work for Intensive Care Unit Survivors after Traumatic Brain Injury with a Follow-up Period of 2 Years

• Published in: Neurologia Medico-Chirurgica Vol. 62; no. 10; pp. 465 - 474
• Main Authors: YABUNO, Satoru, YASUHARA, Takao, MURAI, Satoshi, YUMOTO, Tetsuya, NAITO, Hiromichi, NAKAO, Atsunori, DATE, Isao
• Format: Journal Article
• Language: English
• Published: Tokyo The Japan Neurosurgical Society 15.10.2022; Japan Science and Technology Agency
• Subjects: Age; employment; ICU survivor; Intensive care; moderate to severe traumatic brain injury; Original; Patients; return home; return to work; Traumatic brain injury
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/jns-nmc.2022-0149

Intensive care unit (ICU) survivors after traumatic brain injury (TBI) frequently have serious disabilities with subsequent difficulty in reintegration into society. We aimed to investigate outcomes for ICU survivors after moderate to severe TBI (msTBI) and to identify predictive factors of return home (RH) and return to work (RTW). This single-center retrospective cohort study was conducted on all trauma patients admitted to the emergency ICU of our hospital between 2013 and 2017. Of these patients, adult (age ≥ 18 years) msTBI patients with head Abbreviated Injury Scale ≥ 3 were extracted. We performed univariate/multivariate logistic regression analyses to explore the predictive factors of RH and RTW. Among a total of 146 ICU survivors after msTBI, 107 were included (median follow-up period: 26 months). The RH and RTW rates were 78% and 35%, respectively. Multivariate analyses revealed that the predictive factors of RH were age < 65 years (P < 0.001), HR < 76 bpm (P = 0.015), platelet count ≥ 19× 104/μL (P = 0.0037), D-dimer < 26 μg/mL (P = 0.034), and Glasgow Coma Scale (GCS) score > 8 (P = 0.0015). Similarly, the predictive factors of RTW were age < 65 years (P < 0.001) and GCS score > 8 (P = 0.0039). This study revealed that "age" and "GCS score on admission" affected RH and RTW for ICU survivors after msTBI.