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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32266

    標題: Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study
    作者: Ho, Chung-Han
    Liang, Fu-Wen
    Wang, Jhi-Joung
    Chio, Chung-Ching
    Kuo, Jinn-Rung
    貢獻者: Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp Hlth Care Adm
    Natl Cheng Kung Univ, Coll Med, Res Ctr Hlth Data
    Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth
    Chi Mei Med Ctr, Dept Neurosurg
    Southern Taiwan Univ Sci & Technol, Dept Biotechnol
    關鍵字: Insurance Research Database
    Acute Myocardial-Infarction
    Artificial Neural-Network
    In-Hospital Mortality
    Sleep Disorders
    日期: 2018-01-11
    上傳時間: 2019-11-15 15:47:25 (UTC+8)
    摘要: Traumatic brain injury (TBI) is an important health issue with high mortality. Various complications of physiological and cognitive impairment may result in disability or death after TBI. Grouping of these complications could be treated as integrated post-TBI syndromes. To improve risk estimation, grouping TBI complications should be investigated, to better predict TBI mortality. This study aimed to estimate mortality risk based on grouping of complications among TBI patients. Taiwan's National Health Insurance Research Database was used in this study. TBI was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes: 801-804 and 850-854. The association rule data mining method was used to analyze coexisting complications after TBI. The mortality risk of post-TBI complication sets with the potential risk factors was estimated using Cox regression. A total 139,254 TBI patients were enrolled in this study. Intracerebral hemorrhage was the most common complication among TBI patients. After frequent item set mining, the most common post-TBI grouping of complications comprised pneumonia caused by acute respiratory failure (ARF) and urinary tract infection, with mortality risk 1.55 (95% C. I.: 1.51-1.60), compared with those without the selected combinations. TBI patients with the combined combinations have high mortality risk, especially those aged < 20 years with septicemia, pneumonia, and ARF (HR: 4.95, 95% C. I.: 3.55-6.88). We used post-TBI complication sets to estimate mortality risk among TBI patients. According to the combinations determined by mining, especially the combination of septicemia with pneumonia and ARF, TBI patients have a 1.73-fold increased mortality risk, after controlling for potential demographic and clinical confounders. TBI patients aged<20 years with each combination of complications also have increased mortality risk. These results could provide physicians and caregivers with important information to increase their awareness about sequences of clinical syndromes among TBI patients, to prevent possible deaths among these patients.
    link: http://dx.doi.org/10.1371/journal.pone.0190683
    關聯: Plos One, v.13, n.1, e190683
    Appears in Collections:[醫務管理系(所)] 期刊論文

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