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| 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
Risk-Factors
Sleep Disorders
Ischemic-Stroke
Taiwan
Care
Epidemiology |
| 日期: | 2018-01-11 |
| 上傳時間: | 2019-11-15 15:47:25 (UTC+8) |
| 出版者: | PUBLIC LIBRARY SCIENCE |
| 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 |
| 顯示於類別: | [醫務管理系(所)] 期刊論文
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