Document Detail


Erythropoiesis-stimulating agent administration and survival after severe traumatic brain injury: a prospective study.
MedLine Citation:
PMID:  22430906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To validate previous findings of the effects of erythropoiesis-stimulating agent (ESA) administration following severe traumatic brain injury.
DESIGN: Prospective observational study of all patients with severe traumatic brain injury admitted to the surgical intensive care unit (SICU) at our institution from January 1, 2009, to December 31, 2010 (head Abbreviated Injury Scale score ≥3). Propensity scores were calculated to match patients who received ESA within 30 days after admission to patients who did not receive ESA.
PATIENTS: A total of 566 patients with severe traumatic brain injury were admitted to the SICU. After matching in a 1:1 ratio, 75 matched pairs were analyzed.
MAIN OUTCOME MEASURES: Δ Glasgow Coma Scale score (difference between admission and SICU discharge), in-hospital morbidity, and mortality.
RESULTS: Patients who received ESA and control subjects who did not receive ESA had similar age, mechanisms of injury, vital signs on admission, Abbreviated Injury Scale scores, Injury Severity Scores, and specific intracranial injuries. Patients who received ESA experienced significantly longer lengths of stay in the SICU (mean [SD], 16.1 [1.3] days vs 8.6 [0.8] days; P < .001) and comparable SICU-free days. There was no statistically significant difference in the incidence of major in-hospital complications including deep venous thrombosis and pulmonary embolism when comparing the 2 study cohorts. The Δ Glasgow Coma Scale mean [standard error of the mean] score was 3.0 [0.4] and 2.4 [0.5] in patients who received ESA and those who did not, respectively (P = .33). However, in-hospital mortality was significantly lower for patients who received ESA compared with those who did not (9.3% vs 25.3%; odds ratio, 0.25; 95% CI, 0.08-0.75; P = .012).
CONCLUSIONS: Erythropoiesis-stimulating agent administration demonstrates a significant survival advantage without an increase in morbidity in patients with severe traumatic brain injury.
Authors:
Peep Talving; Thomas Lustenberger; Kenji Inaba; Lydia Lam; Shahin Mohseni; Linda Chan; Demetrios Demetriades
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  147     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-20     Completed Date:  2012-05-04     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-5     Citation Subset:  AIM; IM    
Affiliation:
University of Southern California-Keck School of Medicine, Division of Acute Care Surgery, Department of Surgery, Los Angeles County and University of Southern California Medical Center, CA 90033-4525, USA. peep.talving@surgery.usc.edu
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MeSH Terms
Descriptor/Qualifier:
Abbreviated Injury Scale
Adult
Brain Injuries / drug therapy*,  mortality
Case-Control Studies
Erythropoietin / administration & dosage,  analogs & derivatives*
Female
Glasgow Coma Scale
Hematinics / administration & dosage*
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
Propensity Score
Prospective Studies
Statistics, Nonparametric
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hematinics; 11096-26-7/Erythropoietin; 15UQ94PT4P/darbepoetin alfa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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