Background
Methods
Results
Demographic comparison between head trauma patients with and without VSI
control group | VSI group | |
---|---|---|
male (%) | 70.0 (CI 69.4–70.6) | 74.8 (CI 70.8–79.0) |
mean / median age (years) | 50.9 / 52.0 (SD 22.8) | 44.7 / 45.0 (SD 21.4) |
age ≤ 15 years (%) | 4.5 (CI 4.3–4.6) | 5.7 (CI 4.7–6.9) |
age 16–59 years (%) | 56.6 (CI 56.1–57.1) | 67.3 (CI 63.6–71.1) |
age ≥ 60 years (%) | 38.9 (CI 38.5–39.4) | 27.0 (CI 24.7–29.4) |
Trauma etiology and injury mechanisms
control group | VSI group | |
---|---|---|
traffic accident_car (%) | 18.8 (CI 18.5–19.1) | 28.5 (CI 26.2–31.1) |
traffic accident_motorbike (%) | 9.1 (CI 8.9–9.3) | 9.1 (CI 7.8–10.5) |
traffic accident_bicycle (%) | 11.7 (CI 11.5–12.0) | 11.3 (CI 9.8–12.9) |
traffic accident_pedestrian (%) | 7.7 (CI 7.5–7.9) | 6.8 (CI 5.6–8.0) |
high fall > 3 m (%) | 15.3 (CI 15.1–15.6) | 12.7 (CI 11.2–14.4) |
low fall < 3 m (%) | 27.9 (CI 27.5–28.3) | 13.9 (CI 12.3–15.7) |
punch (%) | 3.0 (CI 2.8–3.1) | 6.5 (CI 5.4–7.8) |
shot (%) | 0.3 (CI 0.3–0.4) | 1.2 (CI 0.7–1.8) |
stab (%) | 0.3 (CI 0.2–0.3) | 0.8 (CI 0.4–1.3) |
other reason (%) | 5.9 (CI 5.8–6.1) | 9.2 (CI 8.0–10.8) |
blunt trauma (%) | 97.8 (CI 97.1–98.5) | 92.9 (CI 88.6–97.4) |
penetrating trauma (%) | 2.2 (CI 2.1–2.3) | 7.1 (CI 5.9–8.4) |
Description of accompanying lesions
control group | VSI group | |
---|---|---|
thorax (AIS > 1) (%) | 43.9 (CI 43.4–44.3) | 46.8 (CI 43.7–50.0) |
abdomen (AIS > 1) (%) | 11.9 (CI 11.6–12.1) | 15.0 (CI 13.3–16.9) |
spine (AIS > 1) (%) | 25.1 (CI 24.7–25.4) | 24.1 (CI 21.9–26.5) |
pelvis (AIS > 1) (%) | 13.1 (CI 12.9–13.4) | 13.5 (CI 11.9–15.2) |
upper extremity (AIS > 1) (%) | 28.8 (CI 28.5–29.2) | 33.9 (CI 31.4–36.7) |
lower extremity (AIS > 1) (%) | 19.7 (CI 19.3–20.0) | 23.4 (CI 21.3–25.7) |
pneumocephalus (%) | 1.1 (CI 1.1–1.2) | 4.1 (CI 3.2–5.1) |
brain contusion (%) | 25.2 (CI 24.8–25.5) | 26.1 (CI 23.9–28.5) |
global brain edema (%) | 8.9 (CI 8.7–9.1) | 9.4 (CI 8.0–10.8) |
pituitary (%) | 0.1 (CI 0.1–0.2) | 0.3 (CI 0.1–0.6) |
brain stem (%) | 2.1 (CI 2.0–2.2) | 2.3 (CI 1.7–3.0) |
soft tissue of the head (%) | 22.7 (CI 22.4–23.0) | 34.8 (CI 32.1–37.5) |
skull fractures (%) | 41.5 (CI 41.0–41.9) | 49.2 (CI 46.2–52.5) |
orbit fractures (%) | 10.2 (CI 9.9–10.4) | 31.6 (CI 29.5–33.7) |
Le Fort fractures (%)a | 7.0 (CI 6.8–7.2) | 22.4 (CI 20.5–24.2) |
epidural hematoma (%) | 10.2 (CI 9.9–10.4) | 12.7 (CI 11.1–14.4) |
subdural hematoma (%) | 33.6 (CI 33.2–34.0) | 23.7 (CI 21.5–26.0) |
subarachnoid hemorrhage (%) | 27.3 (CI 27.0–27.7) | 26.4 (CI 24.1–28.8) |
intracerebral hemorrhage %) | 15.5 (CI 15.3–15.8) | 13.4 (CI 11.7–15.1) |
external carotid artery (%) | 0.0 (CI 0.0–0.0) | 0.1 (CI 0.0–0.3) |
internal carotid artery (%) | 0.3 (CI 0.3–0.3) | 0.7 (CI 0.4–1.2) |
anterior cerebral artery (%) | 0.1 (CI 0.0–0.1) | 0.2 (CI 0.0–0.5) |
middle cerebral artery (%) | 0.2 (CI 0.2–0.3) | 0.2 (CI 0.1–0.5) |
posterior cerebral artery (%) | 0.1 (CI 0.1–0.1) | 0.2 (CI 0.0–0.5) |
vertebral artery (%) | 0.2 (CI 0.2–0.2) | 0.4 (CI 0.1–0.8) |
cerebral veins (%) | 0.4 (CI 0.4–0.5) | 0.8 (CI 0.5–1.4) |
Injury severity and treatment characteristics
control group | VSI group | |
---|---|---|
mean / median ISS | 23.5 / 22.0 (SD 11.0) | 25.1 / 22.0 (SD 10.9) |
preclinical GCS ≤ 8 (%) | 31.2 (CI 30.8–31.6) | 30.3 (CI 27.7–33.3) |
preclinical shock (RR sys ≤ 90 mmHg) (%) | 10.4 (CI 10.2–10.7) | 14.1 (CI 12.2–16.2) |
mean / median intubation time (days) | 5.8 / 1.0 (SD 9.9) | 7.0 / 2.0 (SD 11.0) |
mean / median ICU treatment duration (days) | 10.0 / 5.0 (SD 12.4) | 11.7 / 6.0 (SD 13.8) |
mean / median hospital stay (days) | 20.5 / 15.0 (SD 19.7) | 23.3 / 18.0 (SD 19.9) |
mean / median calculated treatment costs (Euro) | 21,083.1 / 13,266.0 (SD 21,611.2) | 24,511.5 / 16,540.5 (SD 23,825.6) |
Outcome following primary treatment
control group | VSI group | |
---|---|---|
GOS_1a_death > 48 h (%) | 10.1 (CI 9.9–10.4) | 4.7 (CI 3.8–5.9) |
GOS_2_persistent vegetative state (%) | 3.3 (CI 3.1–3.4) | 3.0 (CI 2.3–3.9) |
GOS_3_severe disability (%) | 13.1 (CI 12.8–13.3) | 16.1 (CI 14.3–18.1) |
GOS_4_moderate disability (%) | 26.2 (CI 25.8–26.5) | 29.0 (CI 26.7–31.6) |
GOS_5_good recovery (%) | 47.4 (CI 46.9–47.8) | 47.1 (CI 43.9–50.3) |
discharge_home (%) | 42.2 (CI 41.8–42.6) | 43.8 (CI 40.8–46.9) |
discharge_rehabilitation (%) | 30.8 (CI 30.4–31.2) | 32.9 (CI 30.4–35.5) |
discharge_hospital (%) | 13.7 (CI 13.4–13.9) | 15.2 (CI 13.5–17.1) |
discharge_death or other (%) | 13.3 (CI 13.1–13.6) | 8.1 (CI 6.9–9.5) |