Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Chronic obstructive pulmonary disease (COPD) is associated with impaired neurocognitive recovery in acute traumatic brain injury (TBI) patients. Patients with COPD who suffer from acute TBI are at increased risk of respiratory compromise, one of the most common causes of death within this population. There is sparse amount of literature reporting the impact of COPD on outcomes in this population. This study aims to investigate the effect of COPD on short-term in-hospital outcomes for patients after acute TBI.
This retrospective cohort study utilized the Nationwide Inpatient Sample to identify patients(18+) from 2012-2014 with a primary diagnosis of acute TBI. ICD-9 codes were used to identify patients with COPD and to exclude patients with history of TBI, diabetes insipidus, or missing identifiers(age, gender, death). Data analyses assessed length of stay(LOS), total hospital charges, age of admission and mortality.
Setting : Nationwide Inpatient Sample Administrative Database,2012-2014
Participants (or Animals, Specimens, Cadavers) :
Patient encounters documented in Nationwide Inpatient Sample Database.
Interventions : Interventions:Not applicable.
Main Outcome Measure(s) :
Mortality, total in-hospital charges, length of stay, age of admission.
Of the 26,628 with a primary diagnosis of acute TBI, 1,721 patients were pre-disposed with COPD. In comparison to patients without COPD, significant increases were observed in the COPD group:
· Increased LOS (4.36 vs. 5.50 days,p
· Increased total charges ($57,244.62 vs. $62,366.94,p
· Increased mortality (1.1% vs. 3.1%,p
· Increased age at admission (50.59 vs. 69.85 years,p
Patients with concomitant COPD who are diagnosed with acute TBI suffer from increased LOS, total charges and mortality. The results of this study can aid clinicians in making clinical decisions within this population. Peri-procedural optimization of symptomatic patients is one avenue to improve patient outcomes.
Andrew Dang– Anatomy Fellow, Kansas City University of Medicine and Biosciences, Kansas City, Missouri
Derek Schirmer– Anatomy Fellow, Kansas city university of medicine and Biosciences, Kansas City, Missouri
Russell Arellanes– Anatomy fellow, Kansas City University of Medicine and Biosciences, Kansas City, Missouri
Barth Wright– Professor, Chair, Dept. of Anatomy, Kansas City University of Medicine and Biosciences, Kansas City, Missouri