Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study
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, g...
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| description | 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 |
| doi_str_mv | 10.1371/journal.pone.0190683 |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0190683</identifier><identifier>PMID: 29324771</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biology and Life Sciences ; Brain ; Brain injuries ; Brain Injuries, Traumatic - complications ; Brain Injuries, Traumatic - mortality ; Cognitive ability ; Complications ; Complications and side effects ; Data mining ; Disorders ; Female ; Head injuries ; Health insurance ; Health risks ; Hemorrhage ; Humans ; Intracerebral hemorrhage ; Male ; Medical diagnosis ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Patient outcomes ; Physicians ; Pneumonia ; Population studies ; Population Surveillance ; Population-based studies ; Prevention ; Regression analysis ; Respiratory failure ; Risk analysis ; Risk factors ; Risk management ; Septicemia ; Studies ; Taiwan - epidemiology ; Traumatic brain injury ; Urinary tract ; Urinary tract infections ; Young Adult</subject><ispartof>PloS one, 2018-01, Vol.13 (1), p.e0190683-e0190683</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Ho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Ho et al 2018 Ho et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-213d7eedfb905ff29eb89bdd894c87220013e2774da993886cad3fa8dd0b90093</citedby><cites>FETCH-LOGICAL-c692t-213d7eedfb905ff29eb89bdd894c87220013e2774da993886cad3fa8dd0b90093</cites><orcidid>0000-0001-5925-8477</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764255/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764255/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23864,27922,27923,53789,53791,79370,79371</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29324771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Deli, Mária A.</contributor><creatorcontrib>Ho, Chung-Han</creatorcontrib><creatorcontrib>Liang, Fu-Wen</creatorcontrib><creatorcontrib>Wang, Jhi-Joung</creatorcontrib><creatorcontrib>Chio, Chung-Ching</creatorcontrib><creatorcontrib>Kuo, Jinn-Rung</creatorcontrib><title>Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Brain</subject><subject>Brain injuries</subject><subject>Brain Injuries, Traumatic - complications</subject><subject>Brain Injuries, Traumatic - mortality</subject><subject>Cognitive ability</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Data mining</subject><subject>Disorders</subject><subject>Female</subject><subject>Head injuries</subject><subject>Health insurance</subject><subject>Health risks</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Intracerebral hemorrhage</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Physicians</subject><subject>Pneumonia</subject><subject>Population studies</subject><subject>Population Surveillance</subject><subject>Population-based studies</subject><subject>Prevention</subject><subject>Regression analysis</subject><subject>Respiratory failure</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Risk management</subject><subject>Septicemia</subject><subject>Studies</subject><subject>Taiwan - epidemiology</subject><subject>Traumatic brain injury</subject><subject>Urinary tract</subject><subject>Urinary tract infections</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAYhoso7rr6D0QDgujFjDm0TeOFMCweBhYWPN2GNEk7GdKkm7Tq_HszM91lKnshvWiT73nfJG_zZdlzBJeIUPRu68fghF323uklRAyWFXmQnSNG8KLEkDw8-T7LnsS4hbAgVVk-zs5wKuSUovPMrrteyAH4BrTBj71xLZC-662RYjDeReAd6HwYhDXDDhgHhiDGLtUkqINIY-O2Y9i9ByvgDorfRmnQ-360h-GiFlErEIdR7Z5mjxpho342vS-yH58-fr_8sri6_ry-XF0tZMnwsMCIKKq1amoGi6bBTNcVq5WqWC4rijGEiGhMaa4EY6SqSikUaUSlFEwKyMhF9vLo21sf-RRU5JikkAijJE_E-kgoL7a8D6YTYce9MPww4UPLRUhntJqjWlGWp-1gXOcUlgyShiJMc4SZ0qRIXh-m1ca600pqlyKyM9N5xZkNb_0vXtAyx8Xe4M1kEPzNqOPAOxOltlY47cfIEatYCTGs9vt-9Q96_-kmqhXpAMY1Pq0r96Z8VWBcIJJCTNTyHio9SndGplvVmDQ_E7ydCRIz6D9DK8YY-frb1_9nr3_O2dcn7EYLO2yit-Ph_s3B_AjK4GMMurkLGUG-b4rbNPi-KfjUFEn24vQH3Yluu4D8BQJCB7Y</recordid><startdate>20180111</startdate><enddate>20180111</enddate><creator>Ho, Chung-Han</creator><creator>Liang, Fu-Wen</creator><creator>Wang, Jhi-Joung</creator><creator>Chio, Chung-Ching</creator><creator>Kuo, Jinn-Rung</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5925-8477</orcidid></search><sort><creationdate>20180111</creationdate><title>Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study</title><author>Ho, Chung-Han ; Liang, Fu-Wen ; Wang, Jhi-Joung ; Chio, Chung-Ching ; Kuo, Jinn-Rung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-213d7eedfb905ff29eb89bdd894c87220013e2774da993886cad3fa8dd0b90093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Brain</topic><topic>Brain injuries</topic><topic>Brain Injuries, Traumatic - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ho, Chung-Han</au><au>Liang, Fu-Wen</au><au>Wang, Jhi-Joung</au><au>Chio, Chung-Ching</au><au>Kuo, Jinn-Rung</au><au>Deli, Mária A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-01-11</date><risdate>2018</risdate><volume>13</volume><issue>1</issue><spage>e0190683</spage><epage>e0190683</epage><pages>e0190683-e0190683</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29324771</pmid><doi>10.1371/journal.pone.0190683</doi><tpages>e0190683</tpages><orcidid>https://orcid.org/0000-0001-5925-8477</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biology and Life Sciences Brain Brain injuries Brain Injuries, Traumatic - complications Brain Injuries, Traumatic - mortality Cognitive ability Complications Complications and side effects Data mining Disorders Female Head injuries Health insurance Health risks Hemorrhage Humans Intracerebral hemorrhage Male Medical diagnosis Medicine and Health Sciences Middle Aged Mortality Patient outcomes Physicians Pneumonia Population studies Population Surveillance Population-based studies Prevention Regression analysis Respiratory failure Risk analysis Risk factors Risk management Septicemia Studies Taiwan - epidemiology Traumatic brain injury Urinary tract Urinary tract infections Young Adult |
| title | Impact of grouping complications on mortality in traumatic brain injury: A nationwide population-based study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T05%3A01%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20grouping%20complications%20on%20mortality%20in%20traumatic%20brain%20injury:%20A%20nationwide%20population-based%20study&rft.jtitle=PloS%20one&rft.au=Ho,%20Chung-Han&rft.date=2018-01-11&rft.volume=13&rft.issue=1&rft.spage=e0190683&rft.epage=e0190683&rft.pages=e0190683-e0190683&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0190683&rft_dat=%3Cgale_plos_%3EA522513220%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2390639734&rft_id=info:pmid/29324771&rft_galeid=A522513220&rft_doaj_id=oai_doaj_org_article_1bd794eed22b4706903f71274129de35&rfr_iscdi=true |